Consider the patient devoid of adequate self esteem due to unstable family relations, bullying at school, and the unrealistic media expectations of beauty. Such patients often find themselves in poor nutritional states such as self-starvation states, binging-purging, excess exercise, etc. which often lead to secondary vitamin deficiency disorders, alteration of the menstrual cycle, osteoporosis of the bones, and worsening of the primary psychological state. It is no esoteric statement to claim that environmental trauma has a direct affect on the metabolic and biochemical state of those whom it affects. The next time you notice a decline in the Body Mass Index of a patient, or a gestalt that a loved one is suffering from an eating disorder, consider the primary trauma that may have led up to such a terrible effect. The principles of Osteopathy and other integrative medical practices emphasize ‘root cause’ of patient’s issues for this very reason. Without addressing the primary issue of trauma, it is unlikely the state of the patient will make sustainable change.
Further consider the downstream nutritional effects of societal trauma. Food deserts in less privileged neighborhoods have long term health consequences to those who cannot afford to travel to proper grocery stores. Social determinants of health is becoming a relevant topic in preventive primary care for this reason. One cannot possibly expect obesity to improve, much less the secondary states of diabetes, cardiovascular disease, fatty liver disease, etc. to improve in a community without acknowledgement of the nutritional neglect that such communities face. Historically disenfranchised groups have often been directly or indirectly forced into these resource poor areas. This can be especially evident in the United States in areas such as urban ghettos, native american reservations, and even old mining or steel towns with no sustainable means of support or income. Again, a ‘root cause’ of trauma is more often than what leads to these poor health states. As if that weren’t bad enough, it is no secret that the generationally traumatized often navigate life in a hypersympathetic state (fight-or-flight mode) resulting in hyper-cortisol states and autonomic dysfunction. This evolutionary process keeps the victimized individuals ‘on-edge’ so to speak for survival purposes, but in the long term affects digestion, nutrition, and metabolism which has a global effect on the health of the individual.