Childhood exposure to violence is associated with risk for mental disorders and adult's weight status: a community-based study in Tunisia

Sana El Mhamdi, Andrine Lemieux, Hela Abroug, Arwa Ben Salah, Ines Bouanene, Kamel Ben Salem, Mustafa al'Absi

Research output: Contribution to journalArticle


BACKGROUND: We sought to investigate the relationship between social violence and adult overweight/obesity and the role of common mental disorders (CMD) in mediating this relationship. METHODS: A cross-sectional study was conducted from January to June 2016 in Tunisia. Participants were selected from randomly selected Primary Health Care Centers. The Arabic version of the Adverse Childhood Experiences-International Questionnaire (ACE-IQ) was used. RESULTS: A total of 2120 participants were included. Women exposed to social ACEs had higher rates of overweight/obesity than men (13.5 versus 9.5%; P = 0.004). For women, statistically significant partial mediation effects of CMD were observed for exposure to community violence (% mediated = 17.7%). For men, partial mediation was found for the exposure to peer violence (% mediated = 12.5%). CONCLUSION: Our results provide evidence of the independent increase of overweight/obesity after exposure to social ACEs. Efforts to uncover and address underlying trauma in health care settings may increase the effectiveness of obesity interventions.

Original languageEnglish (US)
Pages (from-to)502-510
Number of pages9
JournalJournal of public health (Oxford, England)
Issue number3
StatePublished - Sep 30 2019



  • Tunisia
  • adverse childhood experiences
  • common mental disorders
  • obesity
  • overweight
  • social violence

PubMed: MeSH publication types

  • Journal Article

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