Secure attachment predicts lower body mass index in young children with histories of child protective services involvement

Background: Children who experience early adversity are at risk for obesity; secure attachment may be a protective factor as it has been linked to reduced obesity risk. Objective: To evaluate whether (1) participation in a parenting intervention and (2) secure attachment were associated with body mass index (BMI) among young children with histories of child protective services (CPS) involvement. Methods: A total of 105 parent-child dyads referred following CPS involvement were randomly assigned to receive Attachment and Biobehavioral Catch-up (ABC), which was designed to increase parental sensitivity, or a control intervention. Attachment security was assessed during infancy, and BMI was assessed at annual follow-up visits until children were 4 years old. Results: Children in the ABC group were more likely to have secure attachments (52%) than children in the control intervention group (32%). Although the ABC intervention did not have a direct effect on children's BMI, secure attachment was associated with a steeper decline in BMI from age 2 to age 4, with secure children showing significantly lower BMI (M = 15.4, SD = 2.08; 16.6% overweight/obese) than insecure children (M = 17.6, SD = 3.81; 35.7% overweight/obese) at age 4. Conclusions: Secure attachment was associated with reduced BMI among CPS-referred children; thus, secure attachment may be a novel target of early obesity prevention efforts.