Childhood Sexual Abuse Review

Publications in top-tier peer-reviewed journals are difficult to produce. If it is original data, it should be done with high levels of statistical rigor and make a novel contribution. If it is a review article, it should offer something that has not been previously offered. This review article by David Wiss, Timothy Brewerton, and Janet Tomiyama offers a new perspective on the link between childhood sexual abuse and obesity! It has recently been published in the prestigious Eating and Weight Disorders journal.

This review employs a biopsychosocial perspective to better understand pathways from childhood sexual abuse to eating disorders, food and drug addictions, and obesity across the life course. Guided by an updated conceptual model, this review delineates how the biological embedding of childhood sexual abuse triggers a cascade of interrelated conditions that often result in failed attempts at weight suppression and eventually obesity.

This model calls into question the longstanding “protective measure” theory that purports individuals exposed to sexual abuse will deliberately or subconsciously gain weight in attempt to prevent future victimization. A more comprehensive understanding of the mechanisms by which childhood sexual abuse becomes biologically embedded may help clinicians and survivors normalize and/or address disordered eating and weight-related outcomes, as well as identify intervention strategies.

Abstract 

In addition to its immediate negative consequences, childhood sexual abuse is associated with lifelong deleterious mental and physical health outcomes. This review employs a biopsychosocial perspective to better understand pathways from childhood sexual abuse to eating disorders, food and drug addictions, and obesity across the life course. Guided by an updated conceptual model, this review delineates how the biological embedding of childhood sexual abuse triggers a cascade of interrelated conditions that often result in failed attempts at weight suppression and eventually obesity. Such biological embedding involves pathways such as inflammation, allostatic load, reward sensitivity, activation of the hypothalamic-pituitary-adrenal axis, epigenetics, and structural and functional changes in the brain. These pathways are in turn theorized to lead to food addiction, substance use disorder, and eating disorders—each with potential pathways toward obesity over time. Predisposing factors to childhood sexual abuse including gender, culture, and age are discussed. This model calls into question the longstanding “protective measure” theory that purports individuals exposed to sexual abuse will deliberately or subconsciously gain weight in attempt to prevent future victimization. A more comprehensive understanding of the mechanisms by which childhood sexual abuse becomes biologically embedded may help clinicians and survivors normalize and/or address disordered eating and weight-related outcomes, as well as identify intervention strategies.

 

David Wiss, MS, RDN is the founder of Nutrition in Recovery, which specializes in: Addictions, Eating Disorders, Mental Health, Body Image, and General Wellness. Mr. Wiss works closely with individuals to help them revolutionize their relationship with food and has shared his expertise with numerous eating disorder and addiction facilities throughout the greater Los Angeles area. David is a nationally recognized expert in nutrition for addiction and is currently working on his Ph.D. in Public Health from UCLA.

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