PTSD and Obesity: A Weighty Matter

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In the case of PTSD, an ounce of prevention may literally be worth a pound of cure. Image by kamuelaboy.

In the case of PTSD, an ounce of prevention may literally be worth a pound of cure. Image by kamuelaboy.

Post Traumatic Stress Disorder or PTSD can occur in the aftermath of rape, physical abuse, witnessing violence, medical trauma and other stressful events. If trauma exposure isn’t bad enough, weight gain may follow the trauma, according to a research team from Harvard, Columbia and Boston universities.

PTSD and Weight Gain

Women are at high risk for PTSD, according to Laura D. Kubzansky, PhD and colleagues “1 in 9 women will meet criteria for the diagnosis during their lifetime.” Using prospective data from the Nurses Health Study, 14,828 the study identified women who had experienced trauma exposure, reported symptoms of PTSD, and had a minimum of two BMI (body mass index) measures.

The Brief Trauma Questionnaire measured the respondents’ exposure to traumatic events by asking questions such as “Before age 18 ever been physically punished or beaten by a parent, caretaker, or teacher so that: you were very frightened; or you thought you would be injured; or you received bruises, cuts, welts, lumps or other injuries?” and “Ever experienced a miscarriage or still birth?”  The age at which the women experienced each trauma was recorded. Additionally, women were asked to rate symptoms such as the extent to which they “Found it hard to have love or affection for other people?”from “None of the Time” to “Most of the Time.”

Although women were targeted in this study, in exclusive interview with Decoded Science. Dr. Karstan Koenan, epidemiologist from Columbia University and part of the research team noted, “Women’s risk of PTSD is twice that of men’s risk and when women develop PTSD the disorder becomes more chronic. However, we have no reason to believe these findings would be different in men.

The good news is that once symptoms had “remitted” women were no more likely to be obese than those without suffering PTSD. Dr. Koenan explained, “Women’s symptoms remitted if they had them in the past but the reported no longer having them in 1989 when the cohort started. Women whose symptoms remitted were not at a higher risk of obesity.”

Implications of the Link Between PTSD and Obesity

Koenan provides three specific recommendations:

First, mental health treatment needs to expand to consider the physical health consequences of mental disorders. For example, this could include assessing health risk behaviors in clients treated for PTSD and making referrals to primary care physicians.

Second, primary care physicians should consider screening for PTSD when they are treating high risk populations  – such as in regions exposed to natural disasters, or military personnel. Persons with PTSD should be considered at elevated risk for adverse physical health outcomes and thus followed accordingly.

Third, policy makers should consider address the mental health needs of the population they aim to reduce obesity or prevent chronic disease.

Prevention and Intervention Key for PTSD Sufferers

The authors favor both prevention of trauma and intervention once it has occurred to decrease negative outcomes like obesity and the diseases associated with obesity. Summing up the key finding, Dr. Koenan states, “Mental and physical health cannot be separated.”

Resources

Kubzansky, L et al. The Weight of Traumatic Stress:A Prospective Study of Posttraumatic Stress Disorder Symptoms and Weight Status in Women. (2013). JAMA Psychiatry. Accessed November 25, 2013.

Harvard Medical School. Nurses Health Study II. Accessed November 25, 2013.

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