How Adverse Childhood Experiences (ACEs) affect your adult health: weight gain, heart disease, and more.
What are Adverse Childhood Experiences (ACEs)? ACEs were first defined in one of the most critical public health studies of our time, and yet most people have never heard of ACEs or the study.
ACEs: The Accidental Discovery Linking Sexual Abuse to Obesity
The story begins in 1985 with a compassionate doctor running a failing obesity clinic in San Diego. Patients would start to have success with weight loss but would suddenly drop the program -- more than half the participants quit every single year -- over the course of five years.
Thankfully, Dr. Vincent Felitti was determined to discover why. He poured through all the patients' medical records. He conducted face-to-face interviews with a couple hundred of the participants who quit. He asked the same set of questions about the patients' history: weight at birth, weight at first grade, weight at high school, age at start of sexual activity, age of marriage, etc.
Weeks passed without any new insights.
Then a miracle happened: Felitti accidentally stumbled upon the problem by accidentally stumbling over his words.
He merged two questions and accidentally asked one patient: How much did you weigh when you were first sexually active? The patient answered 40 pounds and burst into tears as she told the story of her father molesting her when she was four years old.
Shocked at what he heard and realizing what he had accidentally asked, he wondered who else suffered from this same history. He asked other participants the same question and received similar answers.
Sexual abuse was common among people who suffered from obesity.
He learned from his patients that for some of them, food was comfort, but for others, it was safety. For some, eating was a way to quiet the noise and soothe the pain. For others, the weight kept their abusers away. One woman told Felitti that her father didn't abuse her sister "because she was fat."
In 1990, Felitti presented his findings to the North American Association for the Study of Obesity, expecting a warm reception. However, nearly all physicians in attendance balked at his findings.
Yet fate would intervene again.
At dinner, Felitti sat next to Dr. David Williamson, an epidemiologist from the U.S. Centers for Disease Control and Prevention, who was intrigued by Felitti's study. He suggested that while Felitti's study of hundreds of people in an obesity clinic was helpful, he needed thousands of people from a general population to prove his theory.
Felitti said no problem. As a Kaiser Permanente physician, Felitti had access to tens of thousands of patients. Fast forward a few years, thanks to Felitti's and Williamson's partnership, the CDC and Kaiser Permanente conducted a study on over 17,000 people covering ten basic questions about childhood trauma.
The results were astounding:
There was a direct correlation between childhood trauma and chronic illness in adulthood.
More than 66% of participants experienced one or more types of trauma.
More ACEs meant higher risks of medical, mental, and social problems in adulthood.
Today, more healthcare providers know about Felitti and the ACEs study, but it is still not widely known or communicated to a broad population.
Fortunately, some healthcare providers are now seeking training in trauma and ACEs.
The experts who are trained in ACEs, say that knowing your ACEs score is as important as knowing your cholesterol score as key data points in your health and longevity.
What Are ACEs Exactly?
ACEs refer to toxic stressful or traumatic events that occurred over weeks or months before the age of eighteen, such as physical or emotional abuse, neglect, household dysfunction, or exposure to violence or substance abuse. ACEs also include bullying, death of a caregiver, surviving and recovering from a serve accident or health issue, and many other toxic stressful situations.
ACEs are a significant public health issue that affects individuals, families, and communities worldwide.
ACEs can cause lasting effects on the physical, emotional, and social well-being of individuals, including increased risk for chronic diseases, mental health disorders, and substance abuse.
Who is Affected by ACEs?
You might be surprised to learn that adverse childhood experiences (ACEs) happen to all kinds of people in every socioeconomic segment.
In fact, the participants in the ACEs study were 75% white, 11% Latino, 7.5% Asian & Pacific Islander, and 5% black.
Forty percent had college degrees or higher.
Because the study was conducted of Kaiser Permanente members, they all had great health care and solid employment.
Furthermore, the participants were middle-class and upper-middle class. The participants were middle-aged, with the average age 57.
Determining if You Have ACEs
The Kaiser Permanente and CDC study revealed a strong relationship between childhood trauma and health outcomes in adulthood.
The study asked participants about their exposure to ACEs, including physical, emotional, and sexual abuse, as well as household dysfunction, such as parental divorce, domestic violence, substance abuse, and mental illness.
The study found that individuals who experienced four or more ACEs had a significantly higher risk of developing chronic diseases such as heart disease, cancer, and stroke.
If you're wondering if you have ACEs, you can take the ACEs quiz. It is a series of 10 questions that assess exposure to ACEs. The quiz is available on the ACES Too High website and is a useful tool for identifying if you have ACEs.
Keep in mind that the quiz itself might be triggering for you so please consider reviewing it in the presence of a trained professional, such as a psychotherapist who specializes in ACEs.
In addition, it is important to remember that your ACEs score is simply a guideline; it does not predict your future health.
The good news is that there are many contributing factors to offset the adverse childhood experiences. Scientists have defined PCEs -- positive childhood experiences -- that help people overcome the toxic trauma in their lives, such as having a good friend of family member to share your feelings with, having a supportive community or school, and having at least one adult with whom you felt safe. In addition, meeting routinely with a psychotherapist who specializes in adverse childhood experiences can help people manage the pain, shame, and burden of childhood trauma.
What to Do if You Have ACEs
There are many things you can do if you have ACEs to manage the negative effects they may have on your physical and mental health. Seeking support from a mental health professional, such as a psychotherapist, can be an essential step in managing the effects of ACEs. Psychotherapy can help individuals identify and process the trauma they experienced, develop coping skills, and improve their overall well-being.
Functional medicine is another approach that can be helpful for individuals who have ACEs. Functional medicine practitioners focus on treating the root causes of health issues, rather than just the symptoms. They use a personalized approach that takes into account an individual's unique history, lifestyle, and genetic factors. Functional medicine can help individuals address underlying health issues related to ACEs, such as inflammation, chronic pain, and digestive issues.
Benefits of Psychotherapy and Functional Medicine for ACEs
Both psychotherapy and functional medicine can be effective approaches to managing the effects of ACEs. Psychotherapy can help individuals develop coping skills, improve their relationships, and process the trauma they experienced. Functional medicine can help individuals address underlying health issues related to ACEs, such as inflammation, hormone imbalances, and digestive issues.
If you have ACEs, it's essential to seek support from a mental health professional and consider a functional medicine approach to manage the negative effects they may have on your physical and mental health. Remember, healing is possible, and seeking help is the first step. Please contact Christine at dots wellness to begin your journey to healing today.
Sources:
The Adverse Childhood Experiences Study -- The largest, most important public health study you've never heard of. Retrieved from https://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/
Centers for Disease Control and Prevention. Adverse Childhood Experiences (ACEs). Retrieved from https://www.cdc.gov/violenceprevention/aces/index.html.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., ... & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American journal of preventive medicine, 14(4), 245-258.
Greeson, J. K. P., Briggs, E. C., Kisiel, C. L., Layne, C. M., Ake III, G. S., Ko, S. J., ... & Fairbank, J. A. (2011). Complex trauma and mental health in children and adolescents placed in foster care: Findings from the National Child Traumatic Stress Network. Child welfare, 90(6), 91-108.