*4.3. Early Life Experiences*

Finally, adverse childhood events have been repeatedly linked to both obesity and BED [9,10]. It has been argued that adverse experiences may impair coping mechanisms due to mental and emotional perturbations but may also link to metabolic alterations due to stress, and in doing so, promote the development of obesity and BED [11,12]. Consistent with these findings, individual analysis as well as LDA groupings suggest that OB and OB-BED groups can be distinguished from healthy, normal-weight controls on the basis of overall CTQ trauma scores. However, whereas previous research indicated further distinctions between OB-BED and OB groups in terms of traumatic experiences [11,87] these differences were not significant in the present sample. In part, this may have been caused by a smaller sample size of our study or because the sexual and physical abuse scores were slightly higher in the OB group than in the OB-BED group (for similar findings, see [88]). Though further research on more specific contributions may be required, our findings corroborate childhood trauma as a general risk factor for obesity and BED, which should be considered whilst offering treatment.

In a similar vein, attachment styles, formed in early childhood, have been considered in the pathogenesis of BED and obesity [14,15] and emerged as predicting differences of OB-BED and OB groups towards controls. Specifically, OB-BED patients showed elevated RSQ scores for separation anxiety, closeness anxiety, and lack of trust, whereas OB participants differed from controls only with respect to lack of trust. To our knowledge, this is the first study assessing the RSQ in comparing groups of BED, obesity, and normal-weight controls. The findings could suggest that binge eating in obese individuals might result from poor emotional coping mechanisms [89–91]. However, both individual analysis and the LDA did not identify differences in attachment styles as specifically differentiating between OB-BED and OB groups, suggesting that further research on the role of attachment styles in BED is needed.
