Beyond eating and exercise


BYLINE: Michelle Simons, MSW, LMSW-Clinical & Macro, Clinical Editor

Researchers know that obesity is a complex issue and there’s no one answer to solve it. Sedentary lifestyles, and the abundance of unhealthy food options in our culture are well documented and discussed factors.

While the importance of physical activity and a healthy diet are well known and have long been the focus of interventions, the obesity numbers continue to grow. This brings one to wonder: is there something more than knowledge and behavior change that we’re missing? Less often acknowledged is the strong link between obesity and early childhood adversity. Multiple studies have shown that the presence of several Adverse Childhood Experiences (ACEs) increases the likelihood of obesity as an adult.

ACEs are defined as chronically stressful experiences in childhood, such as the loss of a parent through divorce, living with an alcoholic or mentally ill family member, as well as physical, sexual and verbal abuse or neglect. The chronic stress caused by these experiences impacts a child’s biology and brain development, and their presence becomes a major determinant of the child’s future health and social well-being. The more adversity experienced, the higher the risk of health and social problems.

With their brains overloaded with stress hormones, children are more likely to try to cope through unhealthy food, alcohol, tobacco, and other risky behaviors.

This knowledge can help us understand why providing information, motivation, and accountability isn’t enough for many. We must shift our paradigm from “What’s wrong with you, why can’t you eat healthy, get active and lose the weight?” to considering “What impact are your past experiences having on you emotionally and physically today?” Acknowledging the role of stress in health is key.

From this perspective it becomes critical to explore the “why” behind lifestyle behaviors, to provide support around stress prevention and managements strategies, and to promote positive self-esteem to sustainably decrease obesity and improve wellness.

We also need to focus on supporting parents in order to prevent today’s children from experiencing ACEs, which are often passed on from generation to generation, as an upstream approach to preventing obesity in the future. Early trauma screening and referrals for support and treatment are important.

Providing a trauma-informed approach to care prevents re-traumatization and could include using body positive language, focusing on healthy behaviors instead of the scale, avoiding blame and shame and combatting stigma through respecting diversity of body size and exploring body satisfaction.

From a place of self-acceptance can spring the behavior changes necessary for optimal health and wellness.


Michelle Simons

Michelle Simons

MSW, LMSW-Clinical & Macro, Clinical Editor