ACES

What Are ACEs?

Adverse Childhood Experiences (ACEs) are stressful or traumatic events that happen before the age of 18 — such as abuse, neglect, or growing up in a household with mental illness, substance use, or domestic violence. These early hardships can shape brain development, stress responses, and lifelong health in ways we’re still learning to fully understand.

Where the ACE Study Began

The original Adverse Childhood Experiences (ACE) Study didn’t start as a trauma project at all—it began with a puzzle in an obesity clinic in California in the mid-1990s. Dr. Vincent Felitti, a physician at Kaiser Permanente, was perplexed: many patients who successfully lost weight suddenly dropped out or regained it all.

When he dug deeper, a surprising pattern emerged. Patient after patient shared quiet stories of childhood abuse, neglect, or chaotic family environments—painful experiences they had rarely, if ever, discussed. It became clear that for some, the extra weight served as emotional armor, providing protection and buffering them against a world that had once felt unsafe.

This insight invites a deeper question for all of us to consider: What if a body stuck in survival mode for years can quietly drive weight gain? Many of us now hear this called “cortisol belly” — the idea that long-term stress floods the body with cortisol, storing fat around the belly, fueling inflammation, and keeping us locked in high alert, even when the danger has long passed.

Felitti teamed up with Dr. Robert Anda from the Centers for Disease Control and Prevention, launching the groundbreaking ACE Study between 1995 and 1997. They surveyed more than 17,000 adults, asking detailed questions about childhood experiences of abuse, neglect, and household dysfunction. By linking these responses to medical records, they confirmed a powerful relationship: higher ACE scores meant significantly increased risks for depression, heart disease, addiction, and, notably, struggles with weight linked to chronic stress.

The ACE Study fundamentally shifted how we understand trauma’s lasting effects. Rather than viewing childhood adversity as distant, forgotten wounds, the study illuminated them as critical, ongoing drivers of mental and physical health—highlighting the invisible burden the body carries long after childhood ends.

The Philadelphia ACE Project

Harm and healing don’t just begin at home — they’re shaped by what surrounds us, too.

By 2017, the Philadelphia ACE Project asked a simple but powerful question: What happens when adversity lives not only behind closed doors, but out in the street, at school, or woven through a neighbourhood?

In many city blocks, young people were navigating daily threats that stacked up alongside family stress — bullying, community violence, racism, unsafe streets, foster care. When these experiences were added to the ACE checklist, the results were hard to ignore: in some parts of Philadelphia, more than 8 out of 10 children carried at least one ACE.

Harm often hides where support is thin.

The Philly project showed something many communities already know: when families live with fewer resources — unstable housing, underfunded schools, fewer safe places to gather — stress can stick around. People in lower socio-economic areas often face more daily risks and fewer buffers, which means ACEs can become chronic conditions, not just one-off events.

But the truth cuts across income lines, too: adversity, neglect, and fear can appear in wealthier households and so-called “safe” places. No one is immune — but some carry heavier loads for longer, simply because their surroundings keep adding to the weight.

Where healing begins.

The Philly ACE Project reminds us that healing isn’t just about fixing what happens at home — it’s about building communities where children feel safe walking to school, neighbours look out for each other, and racism and neglect lose their power to repeat harm.

Key reminder:

“Harm thrives in isolation — healing grows where safety and connection are strong.”