The mediating role of eating behaviors in the association between adverse childhood experiences and central obesity among young adults.

Emerging evidence highlights the close association between eating behaviors and psychological factors, particularly in the context of obesity development. Although adverse childhood experiences (ACEs) are known to exert profound and lasting impacts on both physical and mental health, current research has not yet established conclusive evidence regarding their specific effects on young adult eating behaviors and subsequent obesity risk. This study therefore aims to address this knowledge gap by examining the association between ACEs and central obesity in young adults, with particular focus on elucidating the potential mediating role of disordered eating patterns. A cross-sectional survey was conducted among 3775 first-year or second-year university students. ACEs (emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect) were assessed by Childhood Trauma Questionnaire-Short Form. The Three-Factor Eating Questionnaire was used to assess eating behaviors including cognitive restraint, uncontrolled eating, and emotional eating. According to the results, the occurrence of ACEs varied significantly by individual factors, including age, gender, household registration type, and family economic status. Participants completed the CTQ-SF questionnaire, and objective anthropometric measurements (including BMI and waist-to-hip ratio) were collected. A higher cumulative ACE score was significantly associated with increased likelihood of cognitive restraint, uncontrolled eating, and emotional eating. Specifically, experiencing physical neglect was associated with a higher probability of engaging in emotional eating. Mediating analysis showed a significant pathway of eating behaviors on ACEs and obesity. This study found that greater physical neglect severity was associated with more pronounced cognitive restraint, uncontrolled eating, and emotional eating behaviors. Higher cumulative ACE scores were also linked to increased severity of uncontrolled and emotional eating behaviors, suggesting the mediation effect of eating behaviors between ACEs and central obesity.