Obesity and adverse childhood experiences in relation to stress during the COVID-19 pandemic: an analysis of the Canadian Longitudinal Study on Aging

BACKGROUND: People with obesity are at increased risk of chronic stress, which may have been exacerbated during the COVID-19 pandemic. Adverse childhood experiences (ACEs) are associated with both obesity and stress and may modify the risk of stress among people with obesity. This study evaluated the associations between obesity, ACEs, and stress during the pandemic, and assessed whether ACEs modified the association between obesity and stress. METHODS: A longitudinal study was conducted among adults aged 50–96 years (n = 23,972) from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Study. Obesity and ACEs were measured pre-pandemic (2015–2018), and stress was measured at the COVID-19 Exit Survey (Sept–Dec 2020). Logistic, Poisson, and negative binomial regression estimated relative risks (RRs) and 95% confidence intervals (CIs). Interaction by ACEs was evaluated on additive and multiplicative scales. RESULTS: People with obesity were more likely to experience an increase in overall stressors (class III obesity vs. healthy weight: adjusted RR = 1.67; 95% CI: 1.12–2.39). Individuals with higher ACE counts had higher risks of pandemic-related stressors and were more likely to perceive the pandemic as negative (4–8 ACEs vs. none: RR = 1.32; 95% CI: 1.19–1.47). The association between obesity and stress was not modified by ACEs. CONCLUSIONS: Increased stress during the first year of the COVID-19 pandemic was observed among people with obesity and among those with ACEs. Long-term outcomes of pandemic-related stress warrant further investigation.