Obesity

Curated, Annotated Bibliography

  Conventional
  Medical Thinking

Obesity is defined by Body Mass Index (BMI) and attributed to a mismatch of energy intake (food) and energy expenditure (activity).  Treatment is focused on decreasing amount and changing character of food (low fat, low carb, etc), increasing exercise, weight loss drugs or bariatric surgery  (US Preventive Services Task Force).

  Systems Biology
  Thinking 

Obesity is a complex neuro-endocrine-inflammatory “brain disease,” in part due to imbalance of signaling molecules leptin & ghrelin and changes in gut microbiome, and can result in pro-inflammatory state.  Highly influenced by sleep disruption and sleep deprivation.  Patterns of food intake and exercise are also significantly affected by complex neurologic factors, not just a person’s conscious choices.

Trauma-Health Equity-
Neurobiology lens

Occurrence and severity of Obesity strongly correlate with severity of childhood adverse experiences, particularly poverty, childhood sexual abuse, and the experience of everyday discrimination.

NEW  Articles

Wall MM et al.  Childhood psychosocial challenges and risk for obesity in US men and women.  Transl Psychiatry  2019.   FREE FULL TEXT ARTICLE 

Review of 24,350 adults.  Childhood poverty was significant risk factor, particularly for women.  Additional risk factors were maltreatment, not finishing high school, and needing to assume early child rearing of own children.

Racz et al.  Links between circadian rhythm, obesity, and the microbiome. Physiol Res 2018.   FREE FULL TEXT ARTICLE 

Factors contributing to obesity include short sleep duration (less than six hours), sleep deficiency, imbalance of leptin vs ghrelin, timing of food consumption, and shift to sweeter foods with high carbohydrate content – influencing the gut microbiome.

Kwarteng JL et al.  Independent Effects of Neighborhood Poverty and Psychosocial Stress on Obesity over Time.   J Urban Health 2017.  FREE FULL TEXT ARTICLE

Residing in neighborhoods with higher concentrations of poverty and exposure to everyday unfair treatment independently heighten risk of central adiposity, mediated by cumulative stress index.

CLASSIC  Articles

Mason SW et al.  Child maltreatment’s heavy toll:  the need for trauma-informed obesity prevention.  Am J Prev Med  2016.   FREE FULL TEXT ARTICLE. 

REVIEW ARTICLE:  Evidence of child maltreatment-obesity association and existing research on physiologic mechanisms.  Highlights impact of physical and sexual abuse, community violence and peer bullying.

Richardson AS et al.  The association between childhood sexual and physical abuse with incident adult severe obesity across 13 years of the National Longitudinal Study of Adolescent Health.  Pediatric Obesity  2014.   FREE FULL TEXT ARTICLE. 

Tracked 10,774 adolescents through age 34.  New cases of severe obesity (BMI >40) of individuals not obese during adolescence found that females reporting sexual and physical abuse had an odds ratio of 2.5 increased risk of severe obesity, males had an odds ratio of 3.6, compared to individuals with no history of abuse.

Wells NM et al.  Early Childhood Poverty, Cumulative Risk Exposure, and Body Mass Index Trajectories Through Young Adulthood.  Am J Pub Health  2010.   FREE FULL TEXT ARTICLE. 

Early childhood poverty leads to accelerated weight gain.  Children who spent all their childhood in poverty had a cumulative risk of twice the rate of obesity by age 9 (as compared to children no childhood poverty) – a risk which persisted into early adulthood.

MORE Articles

Masodkar K et al.  A Review of Posttraumatic Stress Disorder and Obesity:  Exploring the Link.  Primary Care Companion CNS   2016  FREE FULL TEXT ARTICLE.

Matthews KA et al.  Child Abuse is Related to Inflammation in Mid-Life Women:  Role of Obesity.  Brain Behav Immun  2014  FREE FULL TEXT ARTICLE.

Felitti V et al.  Obesity:  problem, solution, or both?  Perm J  2010.  FREE FULL TEXT ARTICLE