Effect of PTSD on Weight and Metabolic Factors among an Overweight and Obese Veteran Population

Veterans with post-traumatic stress disorder (PTSD) have increased rates of overweight/obesity, higher prevalence of obesity-related medical conditions, and greater morbidity and mortality compared to their peers without PTSD. The aim of this study was to assess the impact of PTSD on weight and metabolic parameters as well as the effect of weight change on metabolic indices. In a case-control cohort, we compared PTSD patients (n=364) with those without mental health disorders (NoMH, n=1,008) at baseline (i.e., eight years prior to enrollment) and on the trajectory of changes before the enrollment in the Miami VA MOVE!® (Weight Management for Veterans) program. Multilevel modeling for change was used to investigate changes in weight and physiological markers over time. The sample consisted of 1,372 veterans (1,208 men and 164 women). Mental health status, weight and metabolic parameters were obtained from medical record. The PTSD group was significantly younger, had lower average BMI at baseline, and higher prevalence of weight-related medical conditions. Groups did not differ by gender, race/ethnicity, or Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) status. At baseline, the PTSD group had significantly lower weight, lower HDL-cholesterol, and higher values for glucose and triglycerides than the NoMH group. The PTSD group had a significantly greater slope than NoMH group for HDL-cholesterol (p¬=.011). The difference in rate of change between groups for weight, glucose, and triglycerides was not significant. The sample as a whole showed a significant increase for weight and glucose while total cholesterol, blood pressure, and triglycerides decreased over time. Despite lower weight, veterans with PTSD had greater prevalence of weight related-medical conditions while rate of change in metabolic parameters over time was comparable to NoMH peers. Exploratory analyses showed that weight had a significant negative effect on total cholesterol and blood pressure. PTSD appears to be a significant risk factor for diabetes and overall metabolic dysfunction. The lack of results with regards to the effect of weight on HDL cholesterol, triglycerides, glucose and hemoglobin A1c are not surprising given the complex relationships among weight and these metabolic indices