The prevalence of physical, sexual and mental abuse among adolescents and the association with BMI status

Abstract

BackgroundStudies among adults show an association between abuse and Body Mass Index (BMI) status. When an aberrant BMI status as a consequence of abuse is already prevalent in adolescence, early detection and treatment of abuse might prevent these adolescents from developing serious weight problems and other long-term social, emotional and physical problems in adulthood. Therefore, this study investigated the prevalence of physical, sexual and mental abuse among adolescents and examined the association of these abuse subtypes with BMI status.MethodsIn total, data of 51,856 secondary school students aged 13–16 who had completed a questionnaire on health, well-being and lifestyle were used. BMI was classified into four categories, underweight, normal weight, overweight and obesity. Adolescents reported if they had ever been physically, sexually or mentally abused. Crude and adjusted General Estimation Equation (GEE) analyses were performed to investigate the association between abuse subtypes and BMI status. Analyses were adjusted for ethnicity and parental communication, and stratified for gender and educational level.ResultsEighteen percent of the adolescents reported mental abuse, 7% reported sexual abuse, and 6% reported physical abuse. For underweight, overweight and obese adolescents these percentages were 17%, 25%, and 44%; 7%, 8%, and 16%; and 6%, 8%, 18% respectively. For the entire population, all these subtypes of abuse were associated with being overweight and obese (OR=3.67, 1.79 and 1.50) and all but sexual abuse were associated with underweight (OR=1.21 and 1.12). Stratified analyses showed that physical and sexual abuse were significantly associated with obesity among boys (OR=1.77 and 2.49) and among vocational school students (OR=1.60 and 1.69), and with underweight among girls (OR=1.26 and 0.83).ConclusionMental abuse was reported by almost half of the obese adolescents and associated with underweight, overweight and obesity. Longitudinal analyses are recommended to explore the causality of and the mechanisms explaining this association between abuse and overweight.

Interpersonal violence and overweight in adolescents: The HUNT Study

“…Our main findings substantiate recent but scarce evidence of a significant association between exposure to interpersonal violence and higher or more rapidly increasing BMI starting in adolescence [21,25,26]. In two of these previous studies, only one type of interpersonal violence was assessed, and the sample sizes were smaller than that in the present study.…”

Do Adverse Childhood Experiences Affect Surgical Weight Loss Outcomes?

“…5,6 However, the present study also indicates that a high number of adverse childhood experiences may negatively influence outcomes after bariatric surgery. While bariatric surgery helps patients lose significant amounts of weight and allows for resolution of obesity-related comorbidities, those bariatric patients with a history of childhood abuse, neglect, and household dysfunction may not experience the full benefits of these procedures.…”

“…2 These are collectively termed adverse childhood experiences (ACE) and are known social determinants for numerous health outcomes including depression, obesity, cardiovascular disease, and diabetes. [2][3][4][5][6][7][8][9] However, given the high prevalence of obesity and ACE, little work has gone into studying the influence of ACE on obesity and its treatment outcomes.…”

Family violence and body mass index among adolescents enrolled in the Bolsa Família Program and treated at a primary care clinic

“…The results are conflicting as to the type of disorder -excess weight 15,37 and underweight 38,39 -and in relation to gender 15,38 , type of abuse 39 , and severity of trauma 37 .…”

“…According to Veldwijk et al 39 , as BMI increased, adolescents showed higher rates of violence; 31% had suffered domestic violence. The authors also noted differences according to type of abuse, gender, and schooling.…”