Women who experience both sexual and physical abuse during childhood had a more than twofold increased risk for food addiction in adulthood, a new study found.

The analysis of data on 57,321 women enrolled in the Nurses Health Study II (NHSII) revealed that severe physical and sexual abuse were each associated with a roughly 90 percent increased risk for food addiction, according to Susan A. Mason, PhD, of Brigham and Women’s Hospital in Boston, and colleagues.

Suffering both severe physical and sexual abuse during childhood was associated with a 2.40 relative risk for food addiction later in life, they wrote online in the journal Obesity.

National surveys suggest that more than a third of girls in the U.S. experience some degree of physical or sexual abuse before they reach adulthood, the researchers noted. Studies also have linked childhood abuse with an increased risk for adult obesity and anorexia nervosa and bulimia, but the new analysis is the first to explore an association between child sexual and physical abuse and a wider range of binge eating and food obsession issues now grouped together under the umbrella term ‘food addiction’.

“Our findings suggest that women with a history of childhood abuse are more likely to report engaging in these uncontrolled, addiction-like eating behaviors, and we also found that the harsher the abuse they experienced, the stronger the association,” the investigators wrote.

In 2001, around 90,000 participants who had responded to previous questionnaires were sent a supplemental Violence Questionnaire asking about their history of physical and sexual abuse in childhood. And in 2009, they were sent a survey that included a modified version of the Yale Food Addiction Scale, which is increasingly used to assess compulsive eating behaviors.

The nine-question survey defined food addiction as clinically significant distress over eating, plus three or more of seven symptoms:

• Eating when not hungry four or more times a week
• Worrying about cutting down on certain foods four or more times per week
• Feeling sluggish or fatigued from overeating two or more times per week
• Experiencing negative feelings from overeating that interfere with other activities two or more times per week
• Having physical withdrawal symptoms when cutting down on certain foods two or more times per week
• Continuing to consume the same amount of food despite significant emotional or physical problems due to overeating at any frequency
• Feeling the need to eat an increasing amount of food to reduce distress

Physical abuse was categorized into four categories: none, mild (being pushed, grabbed, or shoved at any frequency or being kicked, bitten, or punched once or hit with something once), moderate (being hit with something more than once or physically attacked once), and severe (being kicked, bitten, or punched or physically attacked more than once or ever choked or burned).

Sexual abuse was characterized as none, sexual touching only, one experience of forced sexual activity, and more than one experience of forced sexual activity.

Overall, 8.2 percent of the sample met the criteria for food addiction, and almost two-thirds of these women were obese in 2009, compared to a quarter of women without food addiction.

Combined experiences of physical and sexual abuse conferred the greatest food addiction risk, and abuse occurring in both childhood and adolescence was associated with greater food addiction risk than abuse in a single time period.

Mason called the findings “exploratory” in an interview with MedPage Today, adding that they must be duplicated and expanded upon to identify possible critical periods of vulnerability and targets for interventions in at-risk people with a history of childhood abuse.

“We are becoming more and more aware of the long-term health consequences associated with childhood abuse,” she said. “But we need a better understanding of the psychological reasons why some women who are victims of this abuse appear to overeat as a coping strategy.”