Childhood Abuse–Related Weight Gain: An Investigation of Potential Resilience Factors

Introduction: Childhood physical, sexual, and emotional abuse are linked to adult obesity, and little is known about what protective factors might mitigate this association. Methods: Data from female (n=4,247) and male (n=1,982) participants in the longitudinal Growing Up Today cohort study from 1996 to 2013 were used to examine whether factors found to promote mental health resilience after abuse also operate as buffers (modifiers) of the abuse–weight status association. At ages 20–25 years, participants were asked about their history of child abuse before age 18 years. Potential resilience factors (modifiers) included childhood family SES, neighborhood safety, supportive relationships with adult nonfamily members, quality of maternal relationship, family structure, religious service attendance, and prayer/meditation. Associations between child abuse and BMI at ages 25–32 years were modeled using linear regression, adjusted for sociodemographic variables and baseline BMI. Potential modifiers were tested with interaction terms. Analyses were run in 2019–2020. Results: Severe abuse was associated with 0.9 kg/m² (95% CI=0.5, 1.2) higher adult BMI than no abuse, corresponding to a 46% increased risk of obesity (95% CI=1.28, 1.67). Less severe abuse was not significantly associated with BMI (β=0.1, 95% CI= −0.2, 0.4). There were no significant interactions between modifiers and abuse. Conclusions: Factors previously found to promote resilience to mental health sequelae after abuse did not modify the association of severe child abuse with higher weight status.