Women with post-traumatic
stress disorder are more likely to be overweight or obese than women without
the condition, a new study suggests.
According to the
researchers, one in nine women will have post-traumatic stress disorder (PTSD)
at some point in her life. That's twice as often as men. Women are more likely
to experience traumatic events, such as rape, which carry a high risk for PTSD,
the study authors said.
"PTSD is not just
about mental health, but also has physical health consequences," said lead
researcher Karestan Koenen, an associate professor of epidemiology at Columbia
University's Mailman School of Public Health, in New York City.
Women with PTSD gain weight
faster than women who do not have the condition, Koenen said. "This, in
turn, has consequences for the risk of heart disease and all the adverse
outcomes associated with obesity," she said.
PTSD linked to weight
How PTSD is linked to
weight gain isn't known, Koenen said, but it may be caused by the high levels
of hormones released because of stress.
These hormones are involved
in a range of body processes, including metabolism, she said.
"In addition, women
with PTSD may change behaviours that lead to obesity," Koenen said.
"There is evidence that people under stress crave high-calorie processed
foods, so it could be diet." These women also are less likely to exercise,
Koenen said the same
problem may exist in men suffering from PTSD, but this hasn't been well
The new report was
published in the online edition of the journal JAMA Psychiatry.
For their research, Koenen
and her colleagues collected data on more than 50 000 women who took part in
the Nurses' Health Study II between 1989 and 2009. Their ages ranged from 22 to
44 at the study's start.
The women were asked about
the worst trauma they experienced and if they had symptoms of PTSD. Symptoms
included re-experiencing the traumatic event, feeling threatened, avoiding
social situations and feeling emotionally numb. PTSD was defined as having four
or more symptoms over a month or more.
Other factors in weight gain
The researchers found that
women originally of normal weight who developed PTSD had a 36% higher risk of
becoming overweight or obese, compared to women who, despite experiencing
trauma, didn't develop PTSD.
This finding held even
after taking into account other factors, such as depression, that have also
been considered major factors in weight gain, the researchers said.
In women who had PTSD
before the study period began, weight increased more rapidly than it did among
women without PTSD.
Although the study found an
association between women having PTSD and a higher risk for obesity, it did not
establish a cause-and-effect.
Impact on physical health
"This important study
highlights, once again, the significant impact that psychological disorders can
have on physical health," said Simon Rego, director of psychology training
at the Montefiore Medical Centre and Albert Einstein College of Medicine, in
New York City. He was not involved with the research.
Rego said trauma and
obesity are both common in today's society. They can cause distress, difficulty
in functioning and disability, he said, and all these conditions are hard to
treat. That's why it's important for doctors to understand the impact of PTSD
symptoms -- not only on mental health, but also on physical health.
Treating PTSD might also
help in reversing weight gain, he said. "Doctors... should be encouraged
to screen for PTSD, especially in populations at high risk for trauma but also
in patients presenting with obesity," he said.
If PTSD symptoms are found,
the patient should be referred to a clinical psychologist or other
mental-health professional with expertise in treating PTSD, Rego said.
To learn more about
post-traumatic stress disorder, visit the US National Institute of Mental Health.