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Obesity and abuse: is there a link?

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Overweight and obesity have multiple origins. A report based on the Nurses’ Health Study II (NHSII), which has been investigating the health and food intake of more than 57 000 women in the USA, states that when women suffer severe abuse during childhood this may be linked to food addiction and obesity in later life (Brauser, 2013). If we keep in mind that South Africa has a terrifyingly high incidence of abuse towards women not only during childhood, but also during infancy, adolescence, young adulthood, adulthood and old age, then this violence towards women could be one of the factors that predisposes our female population to develop such severe overweight and obesity.

Scary statistics

As South Africans prepare for the annual "16 Days of No Violence Against Women" which runs from 25 November until 10 December every year, we need to reflect on just how prevalent abuse against our women of all ages is and how this may impact on other aspects of female life such as body weight.

South Africa has been called "The Rape Capitol of the World" by Interpol and in 2009 the Medical Research Council reported that one in four South African men admitted to raping a woman (Unisa, 2013). This is but one example of the scary statistics we are bombarded with every day.

On the other hand, the statistics of overweight and obesity emerging from the 2012 South African National Health and Nutrition Examination Survey (Sanhanes-1), indicate that obesity among women has increased from 27% in 2003 to 39.2% in 2012, while on average 18% of children are now overweight (Battersby & McLachlan, 2013). 

A study of overweight and obesity coupled with underweight and stunting in female primary school learners in rural KwaZulu-Natal published last month by Tathiah and coworkers (2013) in the South African Medical Journal, starkly underlines the above figures:

  • 9% of these primary school learners were overweight, while 3.8% were obese
  • 4% of the learners were underweight and 9.2% were stunted.

Faced with these overwhelmingly negative statistics regarding both abuse and obesity/overweight in female persons of all ages, the theory that the abuse of women can affect every aspect of their lives including weight and eating habits, gains credence.

American Study

The above mentioned Nurses’ Health Study II (NHSII) found that women who had experienced physical or sexual abuse as children or adolescents were twice as likely to suffer from a food addiction in adulthood than women who were not abused. According to Brauser (2013) women who have a tendency for "uncontrolled eating" may well be exhibiting this behaviour because of prior or even current abuse.

The statistics in America indicate that 3 out of 10 women in the USA will have experienced some form of abuse before they reach their 18th birthday (Brauser, 2013). So although the South African situation regarding rape is dire, it is not unique. The researchers found that women in this study who had suffered sever physical abuse were 90% more likely to be addicted to food.

Researchers realised that this addiction to overeating was "way beyond comfort food". This would imply that women who have been abused, tend to turn to food for more than just comfort. Until this phenomenon has been studied in greater detail we don’t yet know what make women who have been ill-treated and abused turn to eating and food as a solution, or a type of self-therapy. It is possible that hormones in the brain such as serotonin and/or dopamine may play a role, but at this point in time this is just conjecture.

At the moment, the results of this study pose many questions that must be answered before we can prevent women who have been abused from gaining weight and thus compounding their health problems down the line. But it does suggest that the high incidence of abuse in South Africa towards women of all ages may also play a part in our obesity epidemic.

Conclusion

If we are serious about the upcoming "16 Days of No Violence Against Women" and if we can make a change in the attitude towards women in our country we may just also be doing something positive towards turning the tide of female obesity.

References:
Battersby J, McLachlan M, (2013). Editorial: Urban food insecurity: A neglected public health challenge. SAMJ, 103 (10): 716-717; Brauser D (2013). Childhood Abuse linked to Food Addiction. http://www.medscape.com/article805599/; Tathiah N et al (2013). South Africa’s nutritional transition: Overweight, obesity, underweight and stunting in female primary school learners in rural KwaZulu-Natal, South Africa. SAMJ, 103(10):718-723; UNISA, (2013). South Africa, the world’s rape capital. http://www.unisa.ac.za/news/index.php/2013/02/south-africa-the-worlds- rape-capital

(Photo of sad woman from Shutterstock)


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