Childhood Adversity Linked to Obesity in Pregnancy

Author: Norwegian University of Science and Technology
Published: 4 Apr 2024 - Updated: 16 Jul 2026
Publication Details: Peer-Reviewed | Survey, Analysis

Table of Contents:
Synopsis - Definition - Overview - FAQs - Insights, Updates - Related Content

Synopsis

This research examines the connection between adverse childhood experiences and body weight before pregnancy, drawing on data from the large Trøndelag Health Study (HUNT Study) in Norway and follow-up interviews conducted by midwife and PhD candidate Heidi Sandsæter. A total of 6,679 women took part in the quantitative work, which found that the higher a woman's weight, the greater the likelihood she rated her childhood as bad, while 14 women were interviewed in depth about how they understood their own weight development up to motherhood. The findings matter to health professionals, expectant mothers, and families because they show weight is not simply a matter of calories in and calories out, but is often shaped by unmet needs for nutritious food, safety, and secure relationships, along with early exposure to criticism about the body. Published in the peer-reviewed journals PLOS ONE and BMC Reproductive Health, the work is authoritative because it combines population-level statistics with lived personal accounts, offering guidance that can help caregivers approach weight and lifestyle without stigma while supporting the wellbeing of both mother and child.*

At a Glance

1 - Women reporting good childhoods more often attributed weight gain to genetics or disease, and did not blame themselves.
2 - Researchers identified four themes, including unmet essential needs, being under a critical eye, and a struggle with food.
3 - Several participants developed a positive body image during pregnancy, fascinated by what their bodies could do, which researchers note can inhibit obesity development.

Topic Definition

Adverse Childhood Experiences and Weight: Adverse childhood experiences and weight refers to the studied relationship between difficult or harmful events in early life - such as neglect, lack of nutritious food, unstable or unsafe relationships, bullying, exclusion, and persistent criticism about one's body - and a person's likelihood of carrying excess weight in adulthood. Rather than viewing weight purely as a balance of food eaten and energy used, this area of research recognizes that emotional needs unmet in childhood can shape a lasting relationship with food, sometimes leading people to use eating as a way to regulate feelings. Understanding this link helps health professionals move beyond simple diet advice toward more compassionate, individualized care that considers a person's full history.

Overview

Obese Pregnant Women Share Stories of Challenging Childhoods

Sandsæter is a midwife and has seen the development first hand. Increasing numbers of pregnant women are overweight. Heidi Sandsæter has studied what overweight and obese pregnant women perceive as the cause of this development.

"Research in other countries has shown that there is a direct correlation between weight and a difficult childhood in some adults. We wanted to find out if this was also the case in wealthy Norway," says Sandsæter.

She is a PhD candidate at the Department of Public Health and Nursing at the Norwegian University of Science and Technology (NTNU), and has used data from the Trøndelag Health Study (HUNT Study) to look at the connection between childhood experiences and weight before pregnancy. A total of 6679 women participated in the study.

"Through the HUNT Study, the women have answered a simple question: On a scale of very good to very bad, how would they describe their childhood. We found that the higher the weight, the greater the chance of classifying their childhood as bad."

Not all overweight people have experienced difficulties in childhood, but it is something to bear in mind.

Sandsæter believes this shows that weight development isn't as simple as calories in and calories out.

"It is actually very complex, and we see that findings from abroad also apply in Norway. For health professionals, it is important to be aware of this. Not all overweight people have experienced difficulties in childhood, but it is something to bear in mind."

Unmet Needs In Childhood

In a follow-up study, the researchers wanted to hear the stories of the women behind the numbers. They therefore interviewed 14 women who had recently been pregnant.

"We wanted to find out about their understanding of their own weight development up to the point they became mothers," says Sandsæter.

The 14 women came from different places in Trøndelag, were different ages and had different levels of education. Common to them all was that they had a body mass index (BMI) of over 30.

"The women had different stories to tell. Many blamed their weight gain on unmet essential needs during childhood. Some reported not having been given healthy and nutritious food so that their weight could develop normally, or that their needs for support and safe relationships were not met by their parents or peers."

In many cases, it was a combination of both.

"A common factor for those women who said they had felt insecurity was that they had experienced difficult relationships with their parents, or that they had experienced exclusion and bullying throughout much of their childhood," says Sandsæter.

The researchers identified four main themes in the women's stories. Unmet essential needs was one of them. Another was constant negative comments about their body and weight.

"We called this being 'under a critical eye'".

A Struggle With Food

The critical eye didn't just involve the direct or indirect attempts by parents to control their children's weight. It could also be the critical eye of their peers, or that as children or young people they noticed they were 'different' from their peers and therefore became self-critical.

"Their parents may have meant well by watching how much their children ate during meals and constantly referring to their weight, but children quickly notice if something is wrong. They may perceive that their body is not good enough and therefore needs to be changed," says Sandsæter.

The researchers believe that having a negative perception of their own body may rob children of the ability to live their lives without constantly worrying.

"The follow-up that pregnant women receive during pregnancy has a health-promoting focus. It can be a golden opportunity to map the causes behind pregnant women's weight development, and offer guidance on diet and health."

"Constant criticism is not a good way to build self-esteem and a good body image. And having a good body image has been shown to inhibit the development of obesity," says Sandsæter.

A third theme has been called the "struggle with food" by the researchers.

"An interesting finding was that the participants who talked about unmet essential needs used food to regulate their emotions. Some developed a troubled relationship with food early on in their lives, while for others the difficulties developed in adulthood."

Those women who claimed they had a good childhood explained their weight gain by pointing more to other factors such as genetics or disease.

"This is also interesting. They don't blame themselves, like the women with bad childhood experiences do," says Sandsæter.

A Golden Opportunity

Sandsæter believes health professionals must overcome their reluctance to deal with topics such as overweight and obesity in pregnant women.

Overweight and obesity increase the risk of complications, during both pregnancy and childbirth. In particular, the risk of preeclampsia and gestational diabetes increases. Therefore, gaining less weight during pregnancy is recommended for overweight women.

In this way, we can help reduce the risk, not only during pregnancy, but also for the mother and child in the future.

"In order to succeed, it is important to build secure relationships."

Sandsæter believes many people whose work involves prenatal care may find it difficult to talk to women with obesity about topics such as weight, health, diet and activity. She believes health professionals need to gain better knowledge about how to talk about weight and lifestyle in a non-judgemental and motivating way.

"You might be afraid of stigmatising or offending someone, but our study shows that more women gained a more positive view of their own body during pregnancy. They were fascinated by what their bodies were capable of, and they felt fine when their bump started to show. Therefore, we must not represent the 'critical eye' that many feel they are subjected to, or be someone they feel they cannot trust. This is precisely what several of the participants have described as the origin of their obesity development," says Sandsæter.

Sources

Heidi Linn Sandsæter et al: Adverse childhood experiences and pre-pregnancy body mass index in the HUNT study: A population-based cohort study PLOS ONE, 2 May 2023.

Heidi Linn Sandsæter et al: Weight development from childhood to motherhood - embodied experiences in women with pre-pregnancy obesity: a qualitative study BMC - Reproductive Health, 30 January 2024.

Frequently Asked Questions

NOTE: Researched FAQs by Disabled World (DW)

What are adverse childhood experiences?

Adverse childhood experiences are potentially harmful events or conditions during childhood, such as neglect, abuse, bullying, unstable home life, or lack of emotional support, that can affect health and wellbeing later in life.

Does a difficult childhood always cause obesity?

No. The research is clear that not all people who are overweight had a difficult childhood, and many other factors including genetics, disease, and environment also play a role in weight development.

Why is weight monitored during pregnancy?

Weight is monitored because overweight and obesity raise the risk of complications such as preeclampsia and gestational diabetes, and appropriate weight gain helps protect the health of both mother and baby.

How can food be used to regulate emotions?

Some people learn early in life to eat in response to stress, sadness, or insecurity rather than hunger, which can create a troubled relationship with food that continues into adulthood.

What is a healthy way to talk about weight with pregnant women?

A supportive, non-judgmental approach that builds trust, asks open questions about a person's history, and offers practical guidance tends to work better than criticism, which can harm self-esteem and body image.

What is the HUNT Study?

The HUNT Study, or Trøndelag Health Study, is a large ongoing population health survey in Norway that collects data from tens of thousands of participants to support research on many health topics.

Can body image improve during pregnancy?

Yes. The research found that many women developed a more positive view of their bodies during pregnancy, feeling fascinated by what their bodies could do as their pregnancy progressed.

Insights, Analysis, and Developments

Editorial Note: The value of this work lies in how directly it challenges the reluctance many clinicians feel about raising weight during prenatal appointments, reframing pregnancy as a rare moment when women are often more open to reflecting on their bodies and their histories. For midwives, nurses, and doctors, the practical takeaway is a call to ask why a woman's weight has developed as it has, and to do so in a way that builds trust rather than repeating the critical eye that several participants described as the origin of their own struggles. Because overweight and obesity raise the risk of preeclampsia and gestational diabetes, sensitive and well-informed conversations are not only kinder but also medically important for the long-term health of mother and child alike, making this a useful reference for anyone involved in maternal care or supporting family members through pregnancy.*

Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Norwegian University of Science and Technology and published on 4 Apr 2024, this content may have been edited for style, clarity, or brevity.

* Editorial additions by Ian C. Langtree.