Posttraumatic Stress Disorder, Overweight, and Obesity: A Systematic Review and Meta-analysis (original) (raw)

Related papers

Posttraumatic Stress Disorder and Obesity

American Journal of Preventive Medicine, 2009

Background: There is evidence from cross-sectional studies that posttraumatic stress disorder (PTSD) may be associated with obesity. The aim of this study was to examine prospective longitudinal associations between PTSD and obesity in a community sample. Methods: A prospective, longitudinal, epidemiologic study with a representative community sample of adolescents and young adults (Nϭ3021, aged 14-24 years at baseline) was conducted in Munich, Germany. Participants were assessed four times between 1995 and 2005 with the Munich-Composite International Diagnostic Interview. Associations between obesity (BMI Ն30) and DSM-IV PTSD were evaluated in 2007, using cross-sectional and prospective data during young adulthood. Results: The cumulative lifetime incidence of obesity in the sample at 10-year follow-up during young adulthood was 4.3% (women, 4.6%; men, 4.0%). Among women but not among men, obesity was associated with a lifetime history of PTSD (ORϭ3.8; 95% CIϭ1.4, 10.7) in the cross-sectional analyses. Prospective longitudinal analyses from 4-year follow-up to 10-year follow-up confirmed that obesity was predicted by antecedent subthreshold and full PTSD (ORϭ3.0; 95% CIϭ1.3, 7.0) among women but not among men. There were no associations between other mental disorders and obesity in the prospective analyses. Conclusions: The findings indicate a possible causal pathway for the onset of obesity in females with PTSD symptoms. These findings need replication with regard to the pathophysiologic and behavioral mechanisms underlying this relationship.

Posttraumatic stress disorder and body mass index in military veterans

Progress in Neuro-psychopharmacology & Biological Psychiatry, 2006

Introduction: Current management of posttraumatic stress disorder (PTSD) focuses on the psychiatric parameters of this condition. Little has been written about co-morbid overweight and obesity in PTSD. Methods: We used the database of the recently constituted PTSD program at the Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Virginia to assess and better understand the prevalence and severity of overweight and obesity among military veterans with PTSD. Variables assessed included age, decade of life, height, weight, sex, race, and severity and chronicity of PTSD. We used PTSD CheckList-Military Version (PCL-M) to assess current complaints and service-connected disability (SCD) to estimate the long-term severity of PTSD. Results: Of the 221 male veterans extracted from our PTSD database for purposes of this study, 144 (65.2%) were in the age range of 50 to 59 years consistent with Vietnam veterans dominating our study population. Their mean body mass index (BMI) was 30.2 ± 5.8 kg/m 2 placing the typical veteran in the obese range. Far exceeding the current US population rate of 64.5%, 82.8% of our study population was either overweight or obese. Our sample had BMI measurements greater than those reported for non-PTSD veterans and also BMI measurements reported in the literature for veterans with PTSD. Current (PCL-M) and long-term (SCD) markers of PTSD did not relate to obesity. Conclusions: The prevalence of overweight and obesity among our veterans with PTSD far exceeded current US population findings and those of other veteran groups with and without PTSD. PTSD symptoms, whether assessed acutely or chronically, did not explain our findings. Prospective studies of PTSD and comorbidity are needed using larger study populations to better understand the relationships among PTSD, stress, and obesity.

Posttraumatic stress disorder and body mass index in military veterans: Preliminary findings

Progress in Neuro Psychopharmacology and Biological Psychiatry, 2006

Introduction: Current management of posttraumatic stress disorder (PTSD) focuses on the psychiatric parameters of this condition. Little has been written about co-morbid overweight and obesity in PTSD. Methods: We used the database of the recently constituted PTSD program at the Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Virginia to assess and better understand the prevalence and severity of overweight and obesity among military veterans with PTSD. Variables assessed included age, decade of life, height, weight, sex, race, and severity and chronicity of PTSD. We used PTSD CheckList-Military Version (PCL-M) to assess current complaints and service-connected disability (SCD) to estimate the long-term severity of PTSD. Results: Of the 221 male veterans extracted from our PTSD database for purposes of this study, 144 (65.2%) were in the age range of 50 to 59 years consistent with Vietnam veterans dominating our study population. Their mean body mass index (BMI) was 30.2 ± 5.8 kg/m 2 placing the typical veteran in the obese range. Far exceeding the current US population rate of 64.5%, 82.8% of our study population was either overweight or obese. Our sample had BMI measurements greater than those reported for non-PTSD veterans and also BMI measurements reported in the literature for veterans with PTSD. Current (PCL-M) and long-term (SCD) markers of PTSD did not relate to obesity. Conclusions: The prevalence of overweight and obesity among our veterans with PTSD far exceeded current US population findings and those of other veteran groups with and without PTSD. PTSD symptoms, whether assessed acutely or chronically, did not explain our findings. Prospective studies of PTSD and comorbidity are needed using larger study populations to better understand the relationships among PTSD, stress, and obesity.

Posttraumatic stress disorder as a risk factor for obesity among male military veterans

Acta Psychiatrica Scandinavica, 2007

Objective: Obesity is a significant public health problem in the United States, particularly among military veterans with multiple risk factors. Heretofore, posttraumatic stress disorder (PTSD) has not clearly been identified as a risk factor for this condition.Method: We accessed both a national and local database of PTSD veterans.Results: Body mass index (BMI) was greater (P < 0.0001) among male military veterans (n = 1819) with PTSD (29.28 ± 6.09 kg/m2) than those veterans (n = 44 959) without PTSD (27.61 ± 5.99 kg/m2) in a sample of randomly selected veterans from the national database. In the local database of male military veterans with PTSD, mean BMI was in the obese range (30.00 ± 5.65) and did not vary by decade of life (P = 0.242).Conclusion: Posttraumatic stress disorder may be a risk factor for overweight and obesity among male military veterans.

Posttraumatic Stress Disorder and Body Mass Index in Military Veterans: The Richmond Experience

Stress, Trauma, and Crisis: An International Journal, 2006

Military veterans suffering from Posttraumatic Stress Disorder (PTSD) often have comorbid conditions including obesity. They may become disabled either from these comorbid conditions or from PTSD (or from both). Service-connected disability (SCD) is a concept employed by both the Department of Defense and the Department of Veterans Affairs to identify and compensate military veterans with such disabilities. SCD could serve as a measure of the functional impact of PTSD and comorbid obesity and other medical conditions. We reviewed the database of the recently constituted PTSD program at Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, Virginia. Variables assessed included 1) age, 2) decade of life, 3) height, 4) weight, 5) sex, 6) race, 7) employment status, 8) presence or absence of comorbid psychiatric conditions, 9) presence or absence of comorbid medical conditions, and 10) degree of disability. From the height and weight measurements, we calculated body mass index (BMI). We used SCD to estimate degree of disability in terms of total disability (total SCD) and disability ascribed to PTSD (PTSD-SCD). Results indicated that the mean BMI of the study population was 30.3±5.7 kg/m2. This value was consistent with the current definition of obesity. 83.8% of our study population was either overweight or obese. This rate exceeded the US general population level of 64.5%. SCD and comorbid medical conditions had statistically significant relationships with obesity. Race was almost a statistically significant predictor of obesity. Decade of life, employment status and presence/absence of comorbid psychiatric condition did not separate the obese veteran from the non-obese veteran. Analysis of variance (ANOVA) revealed statistical significant differences in BMI (df = 4, F = 2.921, p = 0.022)among various levels of SCD suggesting a threshold effect. PTSD-related SCD, however, did not have a significant relationship with BMI. The prevalence of overweight and obesity among our sample of veterans with PTSD exceeded current U.S. population rates. Comorbid medical conditions may predispose veterans with PTSD to obesity. SCD had a significant relationship with BMI in that there was a threshold effect in which 30% or greater SCD identified veterans with obesity. The cross-sectional nature of the study and the absence of control populations limit the conclusions that may be drawn from our study. Clearly, more definitive studies are needed with much larger study populations.

Post-traumatic stress disorder predicts future weight change in the Millennium Cohort Study

Obesity (Silver Spring, Md.), 2015

To prospectively examine the association between post-traumatic stress disorder (PTSD) and weight change. Longitudinal analysis techniques were used to examine data (2001-2008) from Millennium Cohort Study participants, consisting of U.S. service members and veterans. Using the PTSD Checklist-Civilian Version, PTSD was assessed as none, resolved, new onset, or persistent. Subsequent weight change was assessed as stable (≤3% loss or gain), >3% weight loss, >3% but <10% weight gain, and ≥10% weight gain. Of the 38,352 participants, 2391 (6.2%) had PTSD (838 resolved, 1024 new onset, and 529 persistent), and 11% of participants subsequently had ≥10% weight gain. In multivariable models, PTSD was associated with higher odds of ≥10% weight gain (new onset OR: 1.44 [95% CI: 1.20-1.73]; persistent OR: 1.51 [CI: 1.17-1.96]; resolved OR: 1.30 [CI: 1.05-1.60]) compared with those without PTSD. New-onset and persistent PTSD were also associated with higher odds of >3% weight loss (...

Body mass index relates to males with posttraumatic stress disorder

Journal of the National Medical Association, 2006

Introduction: We looked at the relationships among posttraumatic stress disorder (PTSD), body mass index (BMI) and socioeconomic status (SES) in a newly formed PTSD program at the Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, VA. Methods: We reviewed 265 records and then selected only black and white male veterans (n=252) for study. Variables were: 1) age, 2) decade of life, 3) height, 4) weight, 5) sex, 6) race, and 7) SES (estimated using priority group status). Low income is an important variable determining priority group status. Results: About two-thirds of the veterans were in the age range of 50-59 years (Vietnam veterans). Their mean BMI was 30.2 ± 5.6 kg/M2, and this value did not separate by race. Far exceeding national numbers, 84.1% of our veterans were either overweight or obese. Veterans in the lower priority groups had greater (p=0.029) BMIs than their counterparts in higher priority groups. Conclusions: The pervasiveness of overweight and obesity in our PTSD population was profound. Our observations suggest that low SES is a likely contributor to veterans in lower priority groups having greater BMIs than veterans in higher priority groups.

Is there a relationship between PTSD and complicated obesity? A review of the literature

Biomedicine & Pharmacotherapy, 2019

Recent research strongly supports the hypothesis that posttraumatic stress disorder (PTSD) can be accompanied by obesity and related metabolic disturbances. The mechanisms of these associations are however still not well defined, although disturbed functions in the sympathetic-adrenergic nervous system together with the disturbed release of hormones via the endocrine HPA (hypothalamic-pituitary-adrenal) axis apparently play a role. Leptin resistance and ghrelin excesses might contribute to a disturbed hypothalamic function, and also disturb other cerebral functions, leading to dysfunctional reward signaling and uncontrolled appetite combined with a tendency to alcohol abuse. Secondarily, cortisol stimulation will contribute to the development of central obesity which is known to facilitate the development of metabolic syndrome, including slightly increased levels of inflammatory biomarkers such as C-reactive protein and fibrinogen. While previous therapeutic strategies have focused on early psychotherapeutic interventions in PTSD, the present review emphasizes the importance of better therapeutic approaches regarding the somatic correlates of the syndrome. Strict regulation of dietary meals and food composition with minimal intake of sweets and saturated fat, as well as alcohol avoidance, can provide a basic therapeutic framework. A cognitive psychotherapeutic approach with graduated desensitization toward trigging factors, combined with pharmacotherapy, is discussed in the present review.