Adverse Childhood Experiences and Obesity: Systematic Review of Behavioral Interventions for Women

Objective: Studies have demonstrated a relationship between adverse childhood experiences (ACEs) and adult obesity. Group interventions addressing the psychosocial sequelae of ACES using a trauma-informed approach for adults are well described in the literature. There is also a significant body of literature on the efficacy and proposed structure of interventions addressing weight reduction in adults. However, it is unknown how often interventions addressing attainment of a healthy weight incorporate a specific focus on adult women with a history of ACEs, including childhood abuse and trauma. Method: A systematic review of the literature was conducted using standard approaches. Two additional reviews used broadened inclusion criteria to identify and include group-level interventions that addressed intended outcomes other than obesity. Studies that examined the link between ACEs and obesity as a primary outcome and that provided a description of any potential mediating variables were also identified. The current literature search was conducted as the first step in a multifaceted approach to the development of a set of proposed research protocol designs for an Office on Women's Health-sponsored trauma-informed healthy weight pilot intervention for obese women with a history of ACEs. Results: No articles describing interventions for the treatment of obesity or overweight women with a history of ACEs were identified. Eleven articles describing ACE-related interventions and 15 studies identifying mediators were reviewed. Conclusions: Intervention studies for women with ACEs, other than psychotherapy, are limited. Significant mediators to be considered include anxiety symptoms and internalizing behaviors. Specific recommendations for interventions are provided.