Does the cortisol awakening response link childhood adversity to adult BMI?

Kelly F. Miller, Reout Arbel, Lauren S. Shapiro, Sohyun C. Han, Gayla Margolin

Research output: Contribution to journalArticlepeer-review


Objectives: Childhood adversity is a risk factor for the development of obesity in adulthood. Dysregulated hypothalamic-pituitary-adrenal (HPA) activity, which has been associated separately with both adverse childhood experiences and obesity, has been posited as a mechanism by which stressful experiences influence body mass index (BMI); however, this mechanism has not yet been tested longitudinally. The present study uses multireporter, longitudinal data across three time points to test whether the adolescent cortisol awakening response (CAR), an index of diurnal HPA activity, mediates the association between adversity in childhood and BMI in adulthood. Method: Eighty-two youth, mothers, and fathers reported on adverse childhood experiences from middle childhood to late adolescence. During adolescence, youth provided saliva samples three times each morning across three days, which were assayed for cortisol to calculate CAR. During early adulthood, youth reported height and weight to calculate BMI. Results: Greater adversity predicted flatter CAR and higher young adult BMI. Flatter CAR partially mediated the association between childhood adversity and young adult BMI. Conclusions: Stress-related alterations to HPA activity account in part for the childhood adversity-adult obesity link. Findings are consistent with theoretical models implicating HPA alterations as linking childhood adversity to metabolic and behavioral determinants of BMI in adulthood.

Original languageEnglish
Pages (from-to)526-529
Number of pages4
JournalHealth Psychology
Issue number6
StatePublished - Jun 2018

Bibliographical note

Funding Information:
Funding for this study was provided, in part, by NIH NICHD R01 HD046807 and R21HD072170 awarded to Margolin; NSF Graduate Research Fellowship DGE-0937362 awarded to Miller; NSF SPRF-1606976 awarded to Shapiro; and NSF GRFP DGE-0937362 awarded to Han. We thank the research participants and USC Family Studies Project colleagues, particularly Hannah Rasmussen, Corey Pettit, Elyse L. Guran, and Diana C. Bennett. Preliminary data from this study were presented at the 28th Annual Convention of the Association for Psychological Science.

Publisher Copyright:
© 2018 American Psychological Association.


  • Body mass index
  • Childhood adversity
  • Cortisol awakening response

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology


Dive into the research topics of 'Does the cortisol awakening response link childhood adversity to adult BMI?'. Together they form a unique fingerprint.

Cite this