Military Sexual Trauma and Obesity Among Women Veterans.

Abstract

Posttraumatic stress disorder (PTSD), the experience of military sexual trauma (MST) that may contribute to PTSD, and obesity are three issues that complicate care for our population of new veterans. Our aim was to analyze the association of MST and diagnosed PTSD with obesity among female veterans. Women 20-103 years old using the Veterans Health Administration (VA) in fiscal year 2014 (October 2013-September 2014) with diagnosis and body-mass data were identified in administrative databases (213,985 of 404,183 women). MST was defined by use of an MST clinic or positive MST screen, PTSD by International Classification of Diseases, Ninth Revision (ICD-9) diagnosis code (309.81), and weight categories from body-mass index. The unadjusted chi-square of MST by obesity showed a modest association: 52% MST-affected versus 46% non-MST women were obese. MST status was associated with PTSD (50% MST vs. 15% non-MST women). A multivariable model of obesity adjusting for clinical and demographic covariates estimated a 9% increased risk of obesity from MST (adjusted risk ratio [RR] = 1.09). Younger age, African American race, and chronic disease such as hypertension and dyslipidemia correlated with obesity. Adding PTSD to the model did not affect the association with MST: RR (MST) = 1.09, RR (PTSD) = 1.00 (not significant). This study showed association of MST with obesity in female veterans, independent of PTSD. Weight-gain in patients with trauma may add psychological or medical risk to the burden of disease shouldered by female veterans with MST. Primary care clinicians may need to consider integrating mental health into care of patients with suspected history of trauma especially sexual trauma.