title: PTSD and depression symptoms are associated with binge eating among US Iraq and Afghanistan veterans.
abstract: OBJECTIVE
  US Iraq and Afghanistan Veterans with post-traumatic stress disorder (PTSD) and depression are at increased risk for obesity. Understanding the contribution of health behaviors to this relationship will enhance efforts to prevent and reduce obesity. Therefore, we examined the association of PTSD and depression symptoms with binge eating, a risk factor for obesity, among Iraq/Afghanistan Veterans.
  
  
  METHODS
  Iraq/Afghanistan Veterans were assessed at intake to the VA Puget Sound Healthcare System-Seattle post-deployment clinic (May 2004-January 2007). The Patient Health Questionnaire was used to measure depression and binge eating symptoms, and the PTSD Checklist-Military Version assessed PTSD symptoms.
  
  
  RESULTS
  The majority of the sample (N=332) was male (91.5%) and Caucasian (72.6%), with an average age of 31.1 (SD=8.5) years; 16.3% met depression screening criteria, 37.8% met PTSD screening criteria, and 8.4% met binge eating screening criteria. In adjusted models, those meeting depression (odds ratio (OR)=7.53; 95% CI=2.69, 21.04; p<.001) and PTSD (OR=3.37; 95% CI=1.34, 8.46; p=.01) screening criteria were more likely to meet binge eating screening criteria. Continuous measures of PTSD and depression symptom severity were also associated with meeting binge eating screening criteria (ps<.05).
  
  
  CONCLUSIONS
  PTSD and depression are common conditions among Iraq/Afghanistan Veterans. In the present study, PTSD and depression symptoms were associated with meeting binge eating screening criteria, identifying a possible pathway by which psychiatric conditions lead to disproportionate burden of overweight and obesity in this Veteran cohort. Tailored dietary behavior interventions may be needed for Iraq/Afghanistan Veterans with co-morbid obesity and psychiatric conditions.
authors: VA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; University of Washington, Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific Street, Box 356560, Rm BB1644, Seattle, WA 98195, United States. Electronic address: Katherine.Hoerster@va.gov.
authors: Katherine D
authors: KD
authors: Hoerster
authors: VA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; University of Washington, Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific Street, Box 356560, Rm BB1644, Seattle, WA 98195, United States. Electronic address: Matthew.Jakupcak@va.gov.
authors: Matthew
authors: M
authors: Jakupcak
authors: VA Puget Sound Healthcare System, Seattle Division, Research and Development Service, 1660 S. Columbian Way, Seattle, WA 98108, United States. Electronic address: Robert.Hanson@va.gov.
authors: Robert
authors: R
authors: Hanson
authors: VA Puget Sound Healthcare System, Seattle Division, Mental Health Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; University of Washington, Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific Street, Box 356560, Rm BB1644, Seattle, WA 98195, United States. Electronic address: Miles.McFall@va.gov.
authors: Miles
authors: M
authors: McFall
authors: VA Puget Sound Healthcare System, Seattle Division, Research and Development Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; University of Washington School of Public Health, Departments of Health Services and Epidemiology, 1959 NE Pacific Street, Box 356560, Rm BB1644, Seattle, WA 98195, United States. Electronic address: Gayle.Reiber@va.gov.
authors: Gayle
authors: G
authors: Reiber
authors: Durham Veterans Affairs Medical Center Geriatric Research, Education, and Clinical Center, 508 Fulton St., Durham, NC 27705, United States; Duke University Medical Center, Department of Medicine, 201 Trent Drive, Box 3003 DUMC, Rm 3502 Busse Building, Durham, NC 27710, United States. Electronic address: katherine.hall@duke.edu.
authors: Katherine S
authors: KS
authors: Hall
authors: VA Puget Sound Healthcare System, Seattle Division, Research and Development Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; VA Puget Sound Healthcare System, General Internal Medicine Service, 1660 S. Columbian Way, Seattle, WA 98108, United States; University of Washington Department of Medicine, 1959 N.E. Pacific St. Seattle, WA 98195, United States. Electronic address: Karin.Nelson@va.gov.
authors: Karin M
authors: KM
authors: Nelson
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D002032:Bulimia / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008403:Mass Screening; D009765:Obesity; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D014481:United States; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Binge eating; Depression; Obesity; Post-traumatic stress disorder; Veterans