PTSD and Depression Symptoms are Associated With Binge Eating Among US Iraq and Afghanistan Veterans

Authors
Hoerster, K. D. Jakupcak, M. Hanson, R. McFall, M. Reiber, G. Hall, K. S. Nelson, K. M.
Publication year
2015
Citation Title
PTSD and depression symptoms are associated with binge eating among US Iraq and Afghanistan Veterans.
Journal Name
Eating Behaviors
Journal Volume
17
Page Numbers
115-118
DOI
10.1016/j.eatbeh.2015.01.005
Summary
Veterans who served in either Operation Iraqi Freedom (OIF) or Operation Enduring Freedom (OEF) presenting at a post-deployment clinic participated in a study to examine the association of posttraumatic stress disorder (PTSD) and depression symptoms with binge eating. Veterans who met depression and PTSD screening criteria were more likely to meet binge eating screening criteria.
Key Findings
Meeting depression and PTSD screening criteria was significantly associated with increased odds of meeting binge eating screening criteria.
Similarly, both depression and PTSD symptoms were significantly associated with binge eating.
Thirty-eight percent of the participants met screening criteria for PTSD, 16% met screening criteria for depression, and 8% met binge eating criteria.
Implications for Program Leaders
Provide education for individuals who may be using food to cope with negative emotions and offer more healthy strategies of dealing with anxiety and depression
Disseminate information on issues related to binge eating in classes on managing trauma reactions and depression
Create a list of local referrals for eating disorders for Service members and their families
Implications for Policy Makers
Screen Service members for eating disorders at all stages of the deployment cycle, especially during post-deployment
Encourage research that examines specific interventions for eating disorders, particularly targeting Service members with comorbid PTSD or depression
Recommend that programs incorporate educational information regarding healthy eating habits in their curricula
Methods
OIF/OEF Veterans were assessed at intake in a post-deployment clinic at one Veteran Affairs (VA) hospital; no information was provided about recruitment rates.
Veterans completed measures of PTSD and depression symptoms and three screening items for binge eating.
Statistical analyses were used to predict binge eating from PTSD and depression scores.
Participants
A total of 332 Veterans participated (92% male).
Fifty-two percent of the Veterans were married or cohabitating.
Fifty-five percent of the Veterans had some college, 25% completed high school, 19% completed college or more; most participants (64%) were employed and White (73%).
Among the sample, 75% were in the Army, 10% were in the Marines, and 15% were in other branches.
Limitations
Description of the research methods was very brief and incomplete.
The measure of binge eating was a screening measure and may not have been reliable or comprehensive.
The study was cross-sectional and any causal conclusions are inappropriate.
The sample was clinical (those presenting for services) and results may not be generalizable.
Avenues for Future Research
Explore the chronology of the emergence of symptoms, specifically whether the mental health issues (PTSD and depression) or binge eating disorder emerged first
Examine the concurrent treatment of mental health conditions to find the most effective way to treat mood/PTSD and eating disorders
Examine psychosocial risk factors (e.g., education level, socioeconomic status, etc.) that may impact the relationship between PTSD and eating disorders in Service members
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Objective: US Iraq and Afghanistan Veterans with post-traumatic stress disorder (PTSD) and depression are at increased risk for obesity. Understanding the contribution of health behaviors to this relationship will enhance efforts to prevent and reduce obesity. Therefore, we examined the association of PTSD and depression symptoms with binge eating, a risk factor for obesity, among Iraq/Afghanistan Veterans. Method: Iraq/Afghanistan Veterans were assessed at intake to the Veterans Affairs Puget Sound Healthcare System-Seattle post-deployment clinic (May 2004–January 2007). The Patient Health Questionnaire was used to measure depression and binge eating symptoms, and the PTSD Checklist-Military Version assessed PTSD symptoms. Results: The majority of the sample (N = 332) was male (91.5%) and Caucasian (72.6%), with an average age of 31.1 (SD = 8.5) years; 16.3% met depression screening criteria, 37.8% met PTSD screening criteria, and 8.4% met binge eating screening criteria. In adjusted models, those meeting depression (odds ratio (OR) = 7.53; 95% CI = 2.69, 21.04; p < .001) and PTSD (OR = 3.37; 95% CI = 1.34, 8.46; p = .01) screening criteria were more likely to meet binge eating screening criteria. Continuous measures of PTSD and depression symptom severity were also associated with meeting binge eating screening criteria (ps < .05). Conclusion: PTSD and depression are common conditions among Iraq/Afghanistan Veterans. In the present study, PTSD and depression symptoms were associated with meeting binge eating screening criteria, identifying a possible pathway by which psychiatric conditions lead to disproportionate burden of overweight and obesity in this Veteran cohort. Tailored dietary behavior interventions may be needed for Iraq/Afghanistan Veterans with co-morbid obesity and psychiatric conditions.
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