Obesity in girls and penetrative sexual abuse in childhood.

AIM: To assess the relationship between childhood obesity and penetrative sexual abuse in girls.

METHODS

All obese girls referred to a hospital based pediatric endocrine unit were interviewed by a social worker or psychologist. Questions aimed to elicit any history of physical, emotional and sexual abuse are included. Overweight was defined as BM >95th percentile for age and gender. Body mass index (BMI) Z score (BMIZ) was calculated as measured BMI minus mean BMI for age and gender divided by standard deviation. Penetrative abuse was defined if a history was elicited of forced intercourse with any form of oral, vaginal or anal penetration.

RESULTS

A history of penetrative abuse was elicited in 5 out of 145 (3.5%) obese girls, their mean +/- SD age was 11.9 +/- 3.1 years. Abused girls were significantly more obese than the remainder of the patients (BMIZ 4.76 +/- 1.34 vs. 3.39 +/- 1.28 p = 0.02). Forty-two of all girls had BMI Z scores > or =4, and of these four (9.5%) had been abused. All girls had changes in normal daily behaviour including seductive behaviour, seclusion, self-mutilation and new onset day enuresis.

CONCLUSION

In the evaluation of girls with marked obesity, particularly if associated with behavioural changes and failure to respond to therapy, the possible occurrence of penetrative sexual abuse should be considered.