Association of Military Sexual Trauma, Post-Tramautic Stress Disorder With Obesity in Female Veterans

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Introduction: Post-traumatic stress disorder (PTSD), military sexual trauma (MST), and obesity are among the many medical issues that plague our growing population of new veterans. Our aim is to focus on MST and PTSD and their association with obesity in the female veteran population. Methods: We extracted data from the Veterans Health Administration (VA) from fiscal year FY2009 (Oct 2008-Sep 2009) on women using outpatient care or VA hospitals after excluding patients with schizophrenia. The sample included 285,848 women. We defined obesity and other weight categories from ICD9 diagnosis codes and body-mass index (BMI). PTSD was defined by outpatient visits with ICD9 diagnosis, Military Sexual Trauma (MST) was defined by use of a MST clinic. Covariates included age, race (black, white, Asian/Native Peoples, unknown), married, VA Priority as well as prescribed antipsychotics and Selim count of chronic conditions. Chi-square and logistic regression assessed correlates of obesity. Results: The unadjusted chi-square analysis of MST by obesity diagnosis or BMI >30 found a strong association: 32% non-MST vs 45% MST-affected women were obese. The effect of PTSD was similar: 32% of non-PTSD women vs 42% of women with PTSD were obese. We repeated the analyses adjusting for clinical and demographic covariates, and found a modest level of support for our hypothesis: adjusted odds ratio (OR) 1.14, 95% CI 1.06-1.24 for MST, OR: 1.1, 95% CI 1.06-1.13 for PTSD;. Age, race, depression or bipolar disorder, and chronic disease burden correlated with obesity. Within the subgroup with PTSD, MST was not associated with obesity. Conclusion: This is a pilot study showing the association of MST with obesity in female Veterans. An overlooked phenomenon of weight-gain associated with trauma reactions may be adding cardiovascular and other risk to the burden of disease shouldered by female veterans with MST and/or PTSD. Our study showed increased rates of obesity in women diagnosed with MST and/or PTSD, covarying with additional medical and mental disorders. This is of particular concern due to the growing female veteran population from recent military conflicts and increased incidence and prevalence of MST and PTSD amongst this new wave of veterans. This study highlights the need for paying particular attention to female patients with these complex patterns of physical and mental disorders. Providers should consider interventions such as early referral to dieticians or weight management programs (MOVE).