In the mid-1980s, a group of physicians running a weight-loss program for Kaiser Permanente noted a strange occurrence: Those patients successfully losing weight were those most likely to drop out. Determined to understand what was getting in the way of their success, these doctors, lead by Vincent Felitti in San Diego, launched what has become a massive study of 17,000 people. They found that the underlying cause of obesity is the same underlying cause of alcoholism, cigarette smoking, drug use and depression, as well as a major contributor to many serious physical illnesses affecting adults.
The original study has grown. The U.S. Centers for Disease Control joined forces with Kaiser Permanente. Various studies have ensued, and the original 17,000 participants still are being followed. This research is known as ACE: Adverse Childhood Experiences.
Participants are asked 10 questions about experiences during their childhood such as: Did a parent in the household often push, grab, slap or throw something at you? Did you often feel that no one in your family loved you or thought you were important or special? Did you live with anyone who was a problem drinker or alcoholic or who used street drugs? Answers result in a score of 0 to 10. Participants are then studied to see what physical and emotional illnesses they have or develop.
Their overall findings are that "adverse childhood experiences" are prevalent in our culture. Sadly, they are commonly hidden and unrecognized. From this middle-income population of 17,000, only half had a score of 0. One in 14 had an ACE score higher than 4. Twenty-six percent of women and 16 percent of men reported being molested. Astoundingly, even 50 years after childhood, "adverse childhood experience" scores were the biggest predictor of the physical and emotional health of participants.
As someone's score increases, so does the likelihood that they suffer from some type of addiction, depression, or physical illness. Their research shows that individuals with ACE scores of 4 or above are much more likely to have: cancer, a history of hepatitis, heart disease, emphysema, skeletal fractures, and early death. Similarly, people with ACE scores of 6 are 250 percent more likely to smoke cigarettes than someone with a score of 0. And men with an ACE score of 6 are 4,600 percent more likely to become injection drug users than those with a score of 0.
Getting back to the original question about why obese clients were dropping out of the program, Dr. Felitti and his colleagues found that overeating and obesity were providing unconscious solutions to unrecognized problems relating back to childhood: Participants found sexual and physical safety in their obesity.
So, rather than describing overeating, smoking, alcoholism and unhealthy lifestyle choices as "self-destructive behaviors," the researchers found that they were adaptive in nature. For instance, smoking provides instant relief for anxiety. Drinking numbs emotions.
Over time, however, these attempts at soothing one's self are the same behaviors leading to poor emotional and physical health. Research is also being conducted to understand why some people have similar experiences but don't develop these symptoms.
This column is a simplistic overview of Dr. Felitti's compelling findings. You can take the ACE test yourself, and read more about the research, at the website www.acestudy.org.
The results of the ACE research are slowly being implemented into primary care, social support agencies and the education system. For, as Dr. Felitti stated: "Our findings are disturbing to some because they imply that the basic cause of addiction lie within us and the way we treat each other, not in drug dealers or dangerous chemicals. They suggest that billions of dollars have been spent everywhere except where the answer is to be found."
If you find yourself struggling with an addiction or with emotional and physical issues, taking the ACE test is a good place to start. If you believe that your early life experiences may be negatively influencing you, please seek guidance through your primary care physician or church or by calling a mental health practitioner. Equally important, if you are parenting your children in ways that are harmful, please contact your child's school counselor, pediatrician, the Ron Wood Center, or a mental health professional. Every moment counts.
• Lisa Keating, Ph.D., is a Carson City clinical psychologist.
