Posttraumatic Stress Disorder and Obesity: Evidence for a Risk Association
published online 03 November 2008.
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 (N=3021, 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 ≥30) 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 (OR=3.8; 95% CI=1.4, 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 (OR=3.0; 95% CI=1.3, 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.
aDepartment of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
bDepartment of Biological Psychology, Technical University of Dresden, Dresden, Germany
cMax Planck Institute of Psychiatry, Munich, Germany
dDepartment of Psychiatry, Showa University Fujigaoka Hospital, Yokohama, Japan
eDepartments of Psychiatry and Family and Preventive Medicine, University of California San Diego, La Jolla, California
Address correspondence and reprint requests to: Axel Perkonigg, PhD, Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Strasse 46, 01187 Dresden, Germany
ABSTRACT