Posttraumatic Stress Disorder Diagnosis and Gender are Associated with Accelerated Weight Gain Trajectories in Veterans During the Post-deployment Period

Veterans are disproportionately affected by overweight/obesity and growing evidence suggests that post-deployment is a critical period of accelerated weight gain. We explored the relationship between posttraumatic stress disorder (PTSD) diagnosis, gender, and post-deployment weight trajectories among U.S. Operations Iraqi Freedom, Enduring Freedom, and New Dawn veterans. We used Veterans Affairs electronic health record data from 248,089 veterans (87% men) who, after their last deployment, had at least one medical visit between October 2001 and January 2009 and more than one BMI recorded through September 2010. We analyzed repeated BMI measurements using linear mixed models, with demographics, PTSD and other relevant psychiatric diagnoses as predictors. At the first recorded BMI, veterans' median age was 29, and 59% of women and 77% of men were overweight/obese. They had a median of 6 BMI measurements during a median follow-up of 2.4 years. Controlling for potential confounders, women with a PTSD diagnosis had a yearly BMI growth rate of 0.11 kg/m2 (95% CI 0.09 to 0.13, p < 0.001) higher than women without PTSD. For men, the corresponding PTSD effect was also significant, but slightly lower: 0.07 kg/m2 ((95% CI 0.05 to 0.09, p < 0.001); women-men difference: 0.03 (95% CI 0.01 to 0.06) kg/m2, p = 0.006). The post-deployment period is critical for weight gain, particularly for veterans diagnosed with PTSD and women veterans with PTSD. Efforts are needed to engage post-deployment veterans in weight management services, and to determine whether tailored recruitment/treatment interventions will reduce disparities for veterans with PTSD.