We thank Dr Bachman for his comments on our study. He has raised the interesting possibility that obesity may potentially mediate the relationship between ACEs1 and nonalcoholic fatty liver disease2 that we had not previously considered. Therefore, we reanalyzed our data to examine whether severe obesity (body mass index [calculated as weight in kilograms divided by the square of height in meters] ≥35, as in our study1) is a mediator between ACE and liver problems in adulthood.
Dong M, Dube SR, Felitti VJ, Giles WH, Anda RF. Adverse Childhood Experiences, Obesity, and Liver Disease—Reply. Arch Intern Med. 2004;164(4):460–461. doi:10.1001/archinte.164.4.460-c