Posttraumatic stress disorder and obesity: evidence for a risk association.
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 > or =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.
Perkonigg
Axel
A
Department of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany. axelp11@gmx.net
Owashi
Toshimi
T
Stein
Murray B
MB
Kirschbaum
Clemens
C
Wittchen
Hans-Ulrich
H-U
D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007406:Interview, Psychological; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult