Unhealthy habits – to many, they’re solutions, not problems

On Monday, the local NPR station, Kansas Public Radio, broadcast “Why Unhealthy Habits are Hard to Change”, as part of their regular and always interesting health coverage. Brian Thompson interviewed Kansas State professor Dr. Matthew Palmatier.Picture 7

One thing that Palmatier didn’t bring up is something that many of Dr. Vincent Felitti’s patients told him when he was first exploring the link between the obesity and child trauma: They didn’t see their weight as a problem. They saw it as a solution.

Here’s an example. Several years ago, I attended a conference about child sex abuse. A woman who was quite overweight told her story of years of struggle with trying to shed pounds. She’d been to Weight-Watchers, to special diet clinics, under the care of physicians….you name it, she’d tried it. Each attempt started out well. She lost 10 pounds. 20 pounds. 30 pounds. But at some point, she said, she’d always panic, flee the program and put all the weight back on in a matter of weeks. It took her years to connect this reaction with an event in her childhood. When she was seven, her father raped her in front of her sister, who was just a couple of years older. While he was raping her, he told her the only reason he wasn’t doing the same thing to her older sister is that she was too fat. So, being fat was a way to protect herself.

But that doesn’t mean that everyone who’s obese has suffered child sex abuse, and the ACE Study research bears that out. Food wasn’t my drug of choice, said another woman at this conference.  It was alcohol, which numbed her to the sexual abuse that her father subjected her to, along with his friends. She was very thin. Other people use illegal drugs — cocaine, methamphetemine, heroin, prescription painkillers — or smoking or inappropriate sexual behavior or work. The list goes on, and that list translates into unhealthy lifestyles that lead to adult onset of chronic diseases.

These are grim, grim stories, but very common. Also, childhood trauma doesn’t only refer to one of the three abuses: physical, sexual or emotional. The trauma measured in the ACE Study includes witnessing a mother being battered, a parent who disappears through death or divorce, and a member of the family who’s been imprisoned, is mentally ill or an alcoholic (or other drug abuser).

What’s pretty clear, once you scratch the surface, is that many people who engage in these unhealthy lifestyles feel to their very core that overeating, smoking, binge drinking or keeping a buzz on, having lots of sexual partners, working 80 hours a week — all these things help them cope with some very difficult memories and feelings. For many, these unhealthy habits aren’t problems; they’re solutions. So, it doesn’t seem as if any amount of telling them it’s a problem is going to make much of a difference. So, what will?

ACEs Too High launches!

Labor Day weekend, 2009. Eleven years after the first research paper about the Adverse Childhood Experiences Study came out in the American Journal of Preventive Medicine. Its co-founders thought that the results rang so clear and true that the medical, public health and social services communities would embrace its findings immediately. So far, it’s been a relative handful of very observant social service experts who work in cultures that embrace change. The medical and public health communities are moving more slowly.

Doesn’t it seem as if the most revolutionary ideas take a very long time to wend their way through our society to

ACE pyramid is study's conceptual framework

Pyramid represents ACE Study concept

adoption and integration? Perhaps it takes so long, because the truly revolutionary ideas ping so many different institutions and cultures.

It’s also four years after I wrote my first article about the ACE Study. “Targeting obesity at its roots: Childhood trauma may be at the core of the epidemic of overweight adults” appeared in the Sacramento Bee’s Sunday Forum section. There’s no link, because only staff-written articles remain in their archives. So, I’ve appended the article to the end of this post.

Thanks to Connie Valentine, founder of the Incest Survivors Speakers Bureau in Davis, CA, for introducing me to Dr. Vincent Felitti, retired chief of Kaiser Permanente’s Department of Preventive Medicine in San Diego and Continue reading

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