Publication year
2018
Citation Title
Posttraumatic stress disorder diagnosis and gender are associated with accelerated weight gain trajectories in veterans during the post-deployment period.
Journal Name
Eating Behaviors
Journal Volume
29
Page Numbers
8-13
DOI
10.1016/j.eatbeh.2018.01.002
Summary
Veterans may be prone to being obese and overweight; however, the reason for this is unclear. This study examined the Veterans Affairs (VA) health record data of 248,089 Veterans who returned from war. Results indicated that over half of the Veterans were overweight or obese; furthermore, the posttraumatic stress disorder (PTSD) diagnosis was associated with the body mass index (BMI) trajectory of both male and female Veterans, with a slightly stronger association for female Veterans.
Key Findings
Over half (59%) of female Veterans and 77% of male Veterans were classified as obese or overweight.
Compared to female Veterans without PTSD, those with PTSD were more likely to gain weight (gaining 0.11 more BMI each year).
Male Veterans with PTSD were more likely to gain weight than male Veterans without PTSD (those with PTSD gained 0.07 more BMI each year), but the difference was slightly smaller than in the female subsample.
Implications for Program Leaders
Offer support groups for female Service members who experience PTSD symptoms post-deployment
Provide weight management workshops for Service members who are obese or overweight
Disseminate information regarding the associations between PTSD and weight problems for Service members and where to access resources and services to help with weight management
Implications for Policy Makers
Recommend post-deployment weight management services for Service members in order to help them prevent weight problems
Raise awareness on military basis regarding the association between PTSD symptoms and weight problems
Recommend education of professionals working with Service members and their families on the risk of weight problems after deployment and how to help Service members to prevent it
Methods
Data were obtained from the Veterans Affairs electronic health record; each Veteran had to have at least one medical visit between 2001 and 2009 and also had to have more than one BMI measurement during the study period to qualify for the study.
Measures included each Veteran's PTSD diagnosis and BMI.
Data were analyzed to examine the associations between PTSD diagnosis, gender, and the trajectory of weight gain for Veterans.
Participants
Participants were 248,089 Veterans (87% male); the median age of the female Veterans was 27.60 years whereas the median age of the male Veterans was 28.90 years.
The majority of the female Veterans were White (49%), followed by Black (31%), Latino (11%), and other (9%); similarly, the majority of the male Veterans were White (66%), followed by Black (16%), Latino (12%), and other (6%).
The military branches that the Veterans served were not reported.
Limitations
The sample was limited to Veterans who used the VA health care services, so the findings cannot be generalized to Veterans who did not use the VA services.
The study design made it difficult to examine the causal relationship between PTSD diagnosis and BMI.
The study was solely based on participants' medical data; without examining each individual in person, the results may be subject to errors.
Avenues for Future Research
Recruit Veterans not only from VA but also from other sources to increase the generalizability of the study
Examine the causal relationship between PTSD diagnosis and BMI
Explore other factors (e.g., anxiety diagnosis, number of deployment) that are related to Veterans' weight problems
Focus
Multiple Branches
Target Population
Population Focus
Abstract
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.
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