The Deeper Drivers Beneath Weight and Metabolic Health

When weight returns after medication, it’s tempting to blame the discontinuation of medication or willpower. But the deeper drivers often reach much further back into early life.

Decades of research on Adverse Childhood Experiences (ACEs) show that chronic stress between the ages of 0-18 years old reshapes 5 important organ systems: cardiovascular, metabolic, hormonal, immune, and neurological, altering how the body regulates hunger, insulin, inflammation, and cardiovascular function. ACEs can leave physiological imprints that persist into adulthood even after we may have made peace with our history.

As Dr. Gabor Maté reminds us, “Trauma is not what happens to you, but what happens inside you.” When a child grows up in an environment of emotional instability, threat, abuse or neglect, the body is primed for survival, not repair. Stress hormones stay elevated. Immune signaling shifts. Metabolism adapts to scarcity and danger, not long-term health.

Dr. Vincent Felitti, who led much of the research on ACEs, went further, calling unresolved childhood adversity “the single greatest unaddressed public health threat.” The data showed a clear, dose-dependent relationship between early adversity and adult obesity, diabetes, heart disease, and autoimmune illness.

From this lens, weight and any other chronic disease are not the problem; they're the adaptation. Sustainable metabolic health doesn’t come from overriding the body, but from helping it feel safe enough to let go.

Reflection

If this reframes how you think about weight, health, or your own body, you’re not alone. These conversations are unfolding across medicine right now, and they’re reshaping how we understand health, weight, and the body’s intelligence.

Staying curious about how and why your body may have adapted the way it has is often where meaningful change begins.