Impaired boundaries, sense of self, and personal control: the lifelong trajectory of co-occurring obesity and adverse childhood experiences for adult women

PURPOSE: To deepen the understanding of the phenomenon of co-occurring obesity and ACEs for adult women. METHODS: A qualitative, phenomenological, Reflective Lifeworld Research (RLR) approach was used. Fourteen women living with obesity (BMI ≥ 30) who were between the ages of 18 and 64, and who had at least one ACE participated. RESULTS: The results revealed three essential meanings of the phenomenon: a boundaryless childhood existence, being in and out of control, and a vague or distorted sense of self. Six intertwined constituent meanings further elucidate the phenomenon: obesity as an existential response to ACEs; a chaotic, abusive existence with caregivers; indoctrination into the world of food misuse, weight concerns, and body focus; the critical gaze of others and its impact on the self; burdened with obesity and other persistent health conditions, and adult perspectives on surviving life's challenges. CONCLUSIONS: The women's existential struggles with their bodies and self-worth are compounded by the early genesis of ACEs, the violence and upheaval from ACEs, and the lifelong impact of co-occurring obesity and ACEs. Novel ways for treating co-occurring obesity and ACEs in women are presented. Implications for practice that include establishing concurrent obesity and ACEs management strategies to achieve better health outcomes for women seeking assistance in health care settings are included.