Skip to main content
Top
Published in: Current Diabetes Reports 9/2019

01-09-2019 | Obesity | Psychosocial Aspects (SS Jaser, Section Editor)

Risk Factors of Obesity in Veterans of Recent Conflicts: Need for Diabetes Prevention

Authors: Dora Lendvai Wischik, Cherlie Magny-Normilus, Robin Whittemore

Published in: Current Diabetes Reports | Issue 9/2019

Login to get access

Abstract

Purpose of Review

To identify factors associated with obesity in veterans of the recent, Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) war conflicts.

Recent Findings

Over 44% OEF/OIF/OND veterans are obese (BMI > 30 kg/m2), which exceeds the national obesity prevalence rate of 39% in people younger than 45. Obesity increases morbidity, risk for type 2 diabetes (T2D), and mortality as well as decreases quality of life. A scoping review method was used to identify factors associated with obesity in young veterans. Military exposures, such as multiple deployments and exposure to combat, contribute to challenges in re-integration to civilian life in all veterans. Factors that contribute to increased risk for obesity include changes in eating patterns/eating disorders, changes in physical activity, physical disability, and psychological comorbidity. These conditions can contribute to a rapid weight gain trajectory, changes in metabolism, and obesity.

Summary

Young veterans face considerable challenges related to obesity risk. Further research is needed to better understand young veterans' experiences and health needs in order to adapt or expand existing programs and improve access, engagement, and metabolic outcomes in this vulnerable population.
Literature
4.
go back to reference Cesur R, Sabia JJ, Tekin E. The psychological costs of war: military combat and mental health. J Health Econ. 2013;32(1):51–65.PubMedCrossRef Cesur R, Sabia JJ, Tekin E. The psychological costs of war: military combat and mental health. J Health Econ. 2013;32(1):51–65.PubMedCrossRef
5.
go back to reference Marmar CR. Mental health impact of Afghanistan and Iraq deployment: meeting the challenge of a new generation of veterans. Depress Anxiety. 2009;26(6):493–7.PubMedCrossRef Marmar CR. Mental health impact of Afghanistan and Iraq deployment: meeting the challenge of a new generation of veterans. Depress Anxiety. 2009;26(6):493–7.PubMedCrossRef
6.
go back to reference Ramchand R, Rudavsky R, Grant S, Tanielian T, Jaycox L. Prevalence of, risk factors for, and consequences of posttraumatic stress disorder and other mental health problems in military populations deployed to Iraq and Afghanistan. Curr Psychiatry Rep. 2015;17(5):37.PubMedCrossRef Ramchand R, Rudavsky R, Grant S, Tanielian T, Jaycox L. Prevalence of, risk factors for, and consequences of posttraumatic stress disorder and other mental health problems in military populations deployed to Iraq and Afghanistan. Curr Psychiatry Rep. 2015;17(5):37.PubMedCrossRef
7.
go back to reference Maguen S, Lucenko BA, Reger MA, Gahm GA, Litz BT, Seal KH, et al. The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans. J Trauma Stress. 2010;23(1):86–90.PubMed Maguen S, Lucenko BA, Reger MA, Gahm GA, Litz BT, Seal KH, et al. The impact of reported direct and indirect killing on mental health symptoms in Iraq war veterans. J Trauma Stress. 2010;23(1):86–90.PubMed
9.
go back to reference Eisen SV, Schultz MR, Glickman ME, Vogt D, Martin JA, Osei-Bonsu PE, et al. Postdeployment resilience as a predictor of mental health in operation enduring freedom/operation iraqi freedom returnees. Am J Prev Med. 2014;47(6):754–61.PubMedCrossRef Eisen SV, Schultz MR, Glickman ME, Vogt D, Martin JA, Osei-Bonsu PE, et al. Postdeployment resilience as a predictor of mental health in operation enduring freedom/operation iraqi freedom returnees. Am J Prev Med. 2014;47(6):754–61.PubMedCrossRef
10.
go back to reference Barber J, Bayer L, Pietrzak RH, Sanders KA. Assessment of rates of overweight and obesity and symptoms of posttraumatic stress disorder and depression in a sample of Operation Enduring Freedom/Operation Iraqi Freedom veterans. Mil Med. 2011;176(2):151–5.PubMedCrossRef Barber J, Bayer L, Pietrzak RH, Sanders KA. Assessment of rates of overweight and obesity and symptoms of posttraumatic stress disorder and depression in a sample of Operation Enduring Freedom/Operation Iraqi Freedom veterans. Mil Med. 2011;176(2):151–5.PubMedCrossRef
11.
go back to reference Stefanovics EA, Potenza MN, Pietrzak RH. The physical and mental health burden of obesity in U.S. veterans: results from the National Health and resilience in veterans study. J Psychiatr Res. 2018;103:112–9.PubMedCrossRef Stefanovics EA, Potenza MN, Pietrzak RH. The physical and mental health burden of obesity in U.S. veterans: results from the National Health and resilience in veterans study. J Psychiatr Res. 2018;103:112–9.PubMedCrossRef
12.
go back to reference Maguen S, Madden E, Cohen B, Bertenthal D, Neylan T, Talbot L, et al. The relationship between body mass index and mental health among Iraq and Afghanistan veterans. J Gen Intern Med. 2013;28(Suppl 2):S563–70.PubMedCrossRef Maguen S, Madden E, Cohen B, Bertenthal D, Neylan T, Talbot L, et al. The relationship between body mass index and mental health among Iraq and Afghanistan veterans. J Gen Intern Med. 2013;28(Suppl 2):S563–70.PubMedCrossRef
13.
go back to reference Breland JY, Phibbs CS, Hoggatt KJ, Washington DL, Lee J, Haskell S, et al. The obesity epidemic in the veterans health administration: prevalence among key populations of women and men veterans. J Gen Intern Med. 2017;32(Suppl 1):11–7.PubMedPubMedCentralCrossRef Breland JY, Phibbs CS, Hoggatt KJ, Washington DL, Lee J, Haskell S, et al. The obesity epidemic in the veterans health administration: prevalence among key populations of women and men veterans. J Gen Intern Med. 2017;32(Suppl 1):11–7.PubMedPubMedCentralCrossRef
14.
go back to reference Rush T, LeardMann CA, Crum-Cianflone NF. Obesity and associated adverse health outcomes among US military members and veterans: findings from the millennium cohort study. Obesity (Silver Spring). 2016;24(7):1582–9.CrossRef Rush T, LeardMann CA, Crum-Cianflone NF. Obesity and associated adverse health outcomes among US military members and veterans: findings from the millennium cohort study. Obesity (Silver Spring). 2016;24(7):1582–9.CrossRef
15.
go back to reference Rosenberger PH, Ning Y, Brandt C, Allore H, Haskell S. BMI trajectory groups in veterans of the Iraq and Afghanistan wars. Prev Med. 2011;53(3):149–54.PubMedPubMedCentralCrossRef Rosenberger PH, Ning Y, Brandt C, Allore H, Haskell S. BMI trajectory groups in veterans of the Iraq and Afghanistan wars. Prev Med. 2011;53(3):149–54.PubMedPubMedCentralCrossRef
16.
go back to reference Haskell SG, Brandt C, Burg M, Bastian L, Driscoll M, Goulet J, et al. Incident cardiovascular risk factors among men and women veterans after return from deployment. Med Care. 2017;55(11):948–55.PubMedCrossRef Haskell SG, Brandt C, Burg M, Bastian L, Driscoll M, Goulet J, et al. Incident cardiovascular risk factors among men and women veterans after return from deployment. Med Care. 2017;55(11):948–55.PubMedCrossRef
17.
go back to reference Liu Y, Sayam S, Shao X, Wang K, Zheng S, Li Y, et al. Prevalence of and trends in diabetes among veterans, United States, 2005-2014. Prev Chronic Dis. 2017;14:E135.PubMedPubMedCentral Liu Y, Sayam S, Shao X, Wang K, Zheng S, Li Y, et al. Prevalence of and trends in diabetes among veterans, United States, 2005-2014. Prev Chronic Dis. 2017;14:E135.PubMedPubMedCentral
18.
go back to reference Masodkar K, Johnson J, Peterson MJ. A review of posttraumatic stress disorder and obesity: exploring the link. Prim Care Companion CNS Disord. 2016;18:1. Masodkar K, Johnson J, Peterson MJ. A review of posttraumatic stress disorder and obesity: exploring the link. Prim Care Companion CNS Disord. 2016;18:1.
19.
go back to reference Vieweg WV, Julius DA, Fernandez A, Tassone DM, Narla SN, Pandurangi AK. Posttraumatic stress disorder in male military veterans with comorbid overweight and obesity: psychotropic, antihypertensive, and metabolic medications. Prim Care Companion J Clin Psychiatry. 2006;8(1):25–31.PubMedPubMedCentralCrossRef Vieweg WV, Julius DA, Fernandez A, Tassone DM, Narla SN, Pandurangi AK. Posttraumatic stress disorder in male military veterans with comorbid overweight and obesity: psychotropic, antihypertensive, and metabolic medications. Prim Care Companion J Clin Psychiatry. 2006;8(1):25–31.PubMedPubMedCentralCrossRef
20.
go back to reference Vieweg WV, Julius DA, Bates J, Quinn JF 3rd, Fernandez A, Hasnain M, et al. Posttraumatic stress disorder as a risk factor for obesity among male military veterans. Acta Psychiatr Scand. 2007;116(6):483–7.PubMedCrossRef Vieweg WV, Julius DA, Bates J, Quinn JF 3rd, Fernandez A, Hasnain M, et al. Posttraumatic stress disorder as a risk factor for obesity among male military veterans. Acta Psychiatr Scand. 2007;116(6):483–7.PubMedCrossRef
21.
go back to reference Arksey HOM. L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.CrossRef Arksey HOM. L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.CrossRef
23.
go back to reference Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1–34.CrossRefPubMed Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1–34.CrossRefPubMed
25.
go back to reference Lippa SM, Fonda JR, Fortier CB, Amick MA, Kenna A, Milberg WP, et al. Deployment-related psychiatric and behavioral conditions and their association with functional disability in OEF/OIF/OND veterans. J Trauma Stress. 2015;28(1):25–33.PubMedPubMedCentralCrossRef Lippa SM, Fonda JR, Fortier CB, Amick MA, Kenna A, Milberg WP, et al. Deployment-related psychiatric and behavioral conditions and their association with functional disability in OEF/OIF/OND veterans. J Trauma Stress. 2015;28(1):25–33.PubMedPubMedCentralCrossRef
26.
go back to reference Institute of Medicine (US) Committee on the Initial Assessment of Readjustment Needs of Military Personnel V, and Their Families. Returning Home from Iraq and Afghanistan: Preliminary Assessment of Readjustment Needs of Veterans, Service Members, and Their Families. 2010. https://www.ncbi.nlm.nih.gov/books/NBK220068/. Accessed 14 Jun 2019. Institute of Medicine (US) Committee on the Initial Assessment of Readjustment Needs of Military Personnel V, and Their Families. Returning Home from Iraq and Afghanistan: Preliminary Assessment of Readjustment Needs of Veterans, Service Members, and Their Families. 2010. https://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK220068/​. Accessed 14 Jun 2019.
27.
go back to reference Gilmore AK, Brignone E, Painter JM, Lehavot K, Fargo J, Suo Y, et al. Military sexual trauma and co-occurring posttraumatic stress disorder, depressive disorders, and substance use disorders among returning Afghanistan and Iraq veterans. Women’s Health Issues. 2016;26(5):546–54.PubMedPubMedCentralCrossRef Gilmore AK, Brignone E, Painter JM, Lehavot K, Fargo J, Suo Y, et al. Military sexual trauma and co-occurring posttraumatic stress disorder, depressive disorders, and substance use disorders among returning Afghanistan and Iraq veterans. Women’s Health Issues. 2016;26(5):546–54.PubMedPubMedCentralCrossRef
28.
go back to reference Haskell SG, Gordon KS, Mattocks K, Duggal M, Erdos J, Justice A, et al. Gender differences in rates of depression, PTSD, pain, obesity, and military sexual trauma among Connecticut War Veterans of Iraq and Afghanistan. J Womens Health (Larchmt). 2010;19(2):267–71.CrossRef Haskell SG, Gordon KS, Mattocks K, Duggal M, Erdos J, Justice A, et al. Gender differences in rates of depression, PTSD, pain, obesity, and military sexual trauma among Connecticut War Veterans of Iraq and Afghanistan. J Womens Health (Larchmt). 2010;19(2):267–71.CrossRef
30.
go back to reference Wilson LC. The prevalence of military sexual trauma: a meta-analysis. Trauma Violence Abuse. 2018;19(5):584–97.PubMedCrossRef Wilson LC. The prevalence of military sexual trauma: a meta-analysis. Trauma Violence Abuse. 2018;19(5):584–97.PubMedCrossRef
31.
go back to reference Kimerling R, Street AE, Pavao J, Smith MW, Cronkite RC, Holmes TH, et al. Military-related sexual trauma among veterans health administration patients returning from Afghanistan and Iraq. Am J Public Health. 2010;100(8):1409–12.PubMedPubMedCentralCrossRef Kimerling R, Street AE, Pavao J, Smith MW, Cronkite RC, Holmes TH, et al. Military-related sexual trauma among veterans health administration patients returning from Afghanistan and Iraq. Am J Public Health. 2010;100(8):1409–12.PubMedPubMedCentralCrossRef
32.
go back to reference Blais RK, Brignone E, Maguen S, Carter ME, Fargo JD, Gundlapalli AV. Military sexual trauma is associated with post-deployment eating disorders among Afghanistan and Iraq veterans. Int J Eat Disord. 2017;50(7):808–16.PubMedCrossRef Blais RK, Brignone E, Maguen S, Carter ME, Fargo JD, Gundlapalli AV. Military sexual trauma is associated with post-deployment eating disorders among Afghanistan and Iraq veterans. Int J Eat Disord. 2017;50(7):808–16.PubMedCrossRef
33.
go back to reference Kimerling R, Gima K, Smith MW, Street A, Frayne S. The veterans health administration and military sexual trauma. Am J Public Health. 2007;97(12):2160–6.PubMedPubMedCentralCrossRef Kimerling R, Gima K, Smith MW, Street A, Frayne S. The veterans health administration and military sexual trauma. Am J Public Health. 2007;97(12):2160–6.PubMedPubMedCentralCrossRef
34.
go back to reference Pandey N, Ashfaq SN, Dauterive EW 3rd, MacCarthy AA, Copeland LA. Military sexual trauma and obesity among women veterans. J Women’s Health (Larchmt). 2018;27(3):305–10.CrossRef Pandey N, Ashfaq SN, Dauterive EW 3rd, MacCarthy AA, Copeland LA. Military sexual trauma and obesity among women veterans. J Women’s Health (Larchmt). 2018;27(3):305–10.CrossRef
36.
go back to reference Leehr EJ, Krohmer K, Schag K, Dresler T, Zipfel S, Giel KE. Emotion regulation model in binge eating disorder and obesity--a systematic review. Neurosci Biobehav Rev. 2015;49:125–34.PubMedCrossRef Leehr EJ, Krohmer K, Schag K, Dresler T, Zipfel S, Giel KE. Emotion regulation model in binge eating disorder and obesity--a systematic review. Neurosci Biobehav Rev. 2015;49:125–34.PubMedCrossRef
37.
go back to reference Hoerster KD, Jakupcak M, Hanson R, McFall M, Reiber G, Hall KS, et al. PTSD and depression symptoms are associated with binge eating among US Iraq and Afghanistan veterans. Eat Behav. 2015;17:115–8.PubMedCrossRef Hoerster KD, Jakupcak M, Hanson R, McFall M, Reiber G, Hall KS, et al. PTSD and depression symptoms are associated with binge eating among US Iraq and Afghanistan veterans. Eat Behav. 2015;17:115–8.PubMedCrossRef
38.
go back to reference Schoenfeld AJ, Dunn JC, Bader JO, Belmont PJ Jr. The nature and extent of war injuries sustained by combat specialty personnel killed and wounded in Afghanistan and Iraq, 2003-2011. J Trauma Acute Care Surg. 2013;75(2):287–91.PubMedCrossRef Schoenfeld AJ, Dunn JC, Bader JO, Belmont PJ Jr. The nature and extent of war injuries sustained by combat specialty personnel killed and wounded in Afghanistan and Iraq, 2003-2011. J Trauma Acute Care Surg. 2013;75(2):287–91.PubMedCrossRef
39.
go back to reference Maguen S, Cohen B, Cohen G, Madden E, Bertenthal D, Seal K. Eating disorders and psychiatric comorbidity among Iraq and Afghanistan veterans. Women’s Health Issues. 2012;22(4):e403–6.PubMedCrossRef Maguen S, Cohen B, Cohen G, Madden E, Bertenthal D, Seal K. Eating disorders and psychiatric comorbidity among Iraq and Afghanistan veterans. Women’s Health Issues. 2012;22(4):e403–6.PubMedCrossRef
40.
go back to reference Slane JD, Levine MD, Borrero S, Mattocks KM, Ozier AD, Silliker N, et al. Eating behaviors: prevalence, psychiatric comorbidity, and associations with body mass index among male and female Iraq and Afghanistan veterans. Mil Med. 2016;181(11):e1650–e6.PubMedCrossRef Slane JD, Levine MD, Borrero S, Mattocks KM, Ozier AD, Silliker N, et al. Eating behaviors: prevalence, psychiatric comorbidity, and associations with body mass index among male and female Iraq and Afghanistan veterans. Mil Med. 2016;181(11):e1650–e6.PubMedCrossRef
41.
go back to reference Levine AB, Levine LM, Levine TB. Posttraumatic stress disorder and cardiometabolic disease. Cardiology. 2014;127(1):1–19.PubMedCrossRef Levine AB, Levine LM, Levine TB. Posttraumatic stress disorder and cardiometabolic disease. Cardiology. 2014;127(1):1–19.PubMedCrossRef
42.
go back to reference van den Berk-Clark C, Secrest S, Walls J, Hallberg E, Lustman PJ, Schneider FD, et al. Association between posttraumatic stress disorder and lack of exercise, poor diet, obesity, and co-occuring smoking: a systematic review and meta-analysis. Health Psychol. 2018;37(5):407–16.PubMedPubMedCentralCrossRef van den Berk-Clark C, Secrest S, Walls J, Hallberg E, Lustman PJ, Schneider FD, et al. Association between posttraumatic stress disorder and lack of exercise, poor diet, obesity, and co-occuring smoking: a systematic review and meta-analysis. Health Psychol. 2018;37(5):407–16.PubMedPubMedCentralCrossRef
43.
go back to reference Fulton JJ, Calhoun PS, Wagner HR, Schry AR, Hair LP, Feeling N, et al. The prevalence of posttraumatic stress disorder in operation enduring freedom/operation Iraqi freedom (OEF/OIF) veterans: a meta-analysis. J Anxiety Disord. 2015;31:98–107.PubMedCrossRef Fulton JJ, Calhoun PS, Wagner HR, Schry AR, Hair LP, Feeling N, et al. The prevalence of posttraumatic stress disorder in operation enduring freedom/operation Iraqi freedom (OEF/OIF) veterans: a meta-analysis. J Anxiety Disord. 2015;31:98–107.PubMedCrossRef
44.
go back to reference Cohen BE, Marmar C, Ren L, Bertenthal D, Seal KH. Association of cardiovascular risk factors with mental health diagnoses in Iraq and Afghanistan war veterans using VA health care. JAMA Intern Med. 2009;302(5):489–91. Cohen BE, Marmar C, Ren L, Bertenthal D, Seal KH. Association of cardiovascular risk factors with mental health diagnoses in Iraq and Afghanistan war veterans using VA health care. JAMA Intern Med. 2009;302(5):489–91.
45.
go back to reference •• Blessing EM, Reus V, Mellon SH, Wolkowitz OM, Flory JD, Bierer L, et al. Biological predictors of insulin resistance associated with posttraumatic stress disorder in young military veterans. Psychoneuroendocrinology. 2017;82:91–7. A diagnosis of PTSD in young male Veterans without cardiometabolic disease was associated with increased insulin resistance. Strategies to reduce cardiometabolic risk in this population are indicated.PubMedCrossRef •• Blessing EM, Reus V, Mellon SH, Wolkowitz OM, Flory JD, Bierer L, et al. Biological predictors of insulin resistance associated with posttraumatic stress disorder in young military veterans. Psychoneuroendocrinology. 2017;82:91–7. A diagnosis of PTSD in young male Veterans without cardiometabolic disease was associated with increased insulin resistance. Strategies to reduce cardiometabolic risk in this population are indicated.PubMedCrossRef
46.
go back to reference LeardMann CA, Woodall KA, Littman AJ, Jacobson IG, Boyko EJ, Smith B, et al. Post-traumatic stress disorder predicts future weight change in the millennium cohort study. Obesity (Silver Spring). 2015;23(4):886–92.CrossRef LeardMann CA, Woodall KA, Littman AJ, Jacobson IG, Boyko EJ, Smith B, et al. Post-traumatic stress disorder predicts future weight change in the millennium cohort study. Obesity (Silver Spring). 2015;23(4):886–92.CrossRef
48.
go back to reference Batch BC, Goldstein K, Yancy WS Jr, Sanders LL, Danus S, Grambow SC, et al. Outcome by gender in the veterans health administration motivating overweight/obese veterans everywhere weight management program. J Women’s Health. 2018;27(1):32–9.CrossRef Batch BC, Goldstein K, Yancy WS Jr, Sanders LL, Danus S, Grambow SC, et al. Outcome by gender in the veterans health administration motivating overweight/obese veterans everywhere weight management program. J Women’s Health. 2018;27(1):32–9.CrossRef
49.
go back to reference Koo KH, Hebenstreit CL, Madden E, Seal KH, Maguen S. Race/ethnicity and gender differences in mental health diagnoses among Iraq and Afghanistan veterans. Psychiatry Res. 2015;229(3):724–31.PubMedCrossRef Koo KH, Hebenstreit CL, Madden E, Seal KH, Maguen S. Race/ethnicity and gender differences in mental health diagnoses among Iraq and Afghanistan veterans. Psychiatry Res. 2015;229(3):724–31.PubMedCrossRef
50.
go back to reference Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67(3):220–9.CrossRefPubMed Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67(3):220–9.CrossRefPubMed
51.
go back to reference Littman AJ, Jacobson IG, Boyko EJ, Powell TM, Smith TC. Millennium cohort study T. weight change following US military service. Int J Obes. 2013;37(2):244–53.CrossRef Littman AJ, Jacobson IG, Boyko EJ, Powell TM, Smith TC. Millennium cohort study T. weight change following US military service. Int J Obes. 2013;37(2):244–53.CrossRef
52.
go back to reference Kittel JA, DeBeer BB, Kimbrel NA, Matthieu MM, Meyer EC, Gulliver SB, et al. Does body mass index moderate the association between posttraumatic stress disorder symptoms and suicidal ideation in Iraq/Afghanistan veterans? Psychiatry Res. 2016;244:123–9.PubMedPubMedCentralCrossRef Kittel JA, DeBeer BB, Kimbrel NA, Matthieu MM, Meyer EC, Gulliver SB, et al. Does body mass index moderate the association between posttraumatic stress disorder symptoms and suicidal ideation in Iraq/Afghanistan veterans? Psychiatry Res. 2016;244:123–9.PubMedPubMedCentralCrossRef
54.
go back to reference Hoerster KD, Jakupcak M, McFall M, Unutzer J, Nelson KM. Mental health and somatic symptom severity are associated with reduced physical activity among US Iraq and Afghanistan veterans. Prev Med. 2012;55(5):450–2.PubMedCrossRef Hoerster KD, Jakupcak M, McFall M, Unutzer J, Nelson KM. Mental health and somatic symptom severity are associated with reduced physical activity among US Iraq and Afghanistan veterans. Prev Med. 2012;55(5):450–2.PubMedCrossRef
55.
go back to reference Belmont PJ Jr, Goodman GP, Zacchilli M, Posner M, Evans C, Owens BD. Incidence and epidemiology of combat injuries sustained during "the surge" portion of operation Iraqi freedom by a U.S. Army brigade combat team. J Trauma. 2010;68(1):204–10.PubMedCrossRef Belmont PJ Jr, Goodman GP, Zacchilli M, Posner M, Evans C, Owens BD. Incidence and epidemiology of combat injuries sustained during "the surge" portion of operation Iraqi freedom by a U.S. Army brigade combat team. J Trauma. 2010;68(1):204–10.PubMedCrossRef
56.
go back to reference Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med. 2008;358(5):453–63.PubMedCrossRef Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med. 2008;358(5):453–63.PubMedCrossRef
57.
go back to reference Kontos AP, Kotwal RS, Elbin RJ, Lutz RH, Forsten RD, Benson PJ, et al. Residual effects of combat-related mild traumatic brain injury. J Neurotrauma. 2013;30(8):680–6.PubMedCrossRef Kontos AP, Kotwal RS, Elbin RJ, Lutz RH, Forsten RD, Benson PJ, et al. Residual effects of combat-related mild traumatic brain injury. J Neurotrauma. 2013;30(8):680–6.PubMedCrossRef
58.
go back to reference Ling G, Bandak F, Armonda R, Grant G, Ecklund J. Explosive blast neurotrauma. J Neurotrauma. 2009;26(6):815–25.PubMedCrossRef Ling G, Bandak F, Armonda R, Grant G, Ecklund J. Explosive blast neurotrauma. J Neurotrauma. 2009;26(6):815–25.PubMedCrossRef
59.
go back to reference McGlinchey RE, Milberg WP, Fonda JR, Fortier CB. A methodology for assessing deployment trauma and its consequences in OEF/OIF/OND veterans: the TRACTS longitudinal prospective cohort study. Int J Methods Psychiatr Res. 2017;26(3):e1556.CrossRefPubMedCentral McGlinchey RE, Milberg WP, Fonda JR, Fortier CB. A methodology for assessing deployment trauma and its consequences in OEF/OIF/OND veterans: the TRACTS longitudinal prospective cohort study. Int J Methods Psychiatr Res. 2017;26(3):e1556.CrossRefPubMedCentral
60.
go back to reference Cifu DX, Taylor BC, Carne WF, Bidelspach D, Sayer NA, Scholten J, et al. Traumatic brain injury, posttraumatic stress disorder, and pain diagnoses in OIF/OEF/OND veterans. J Rehabil Res Dev. 2013;50(9):1169–76.PubMedCrossRef Cifu DX, Taylor BC, Carne WF, Bidelspach D, Sayer NA, Scholten J, et al. Traumatic brain injury, posttraumatic stress disorder, and pain diagnoses in OIF/OEF/OND veterans. J Rehabil Res Dev. 2013;50(9):1169–76.PubMedCrossRef
61.
go back to reference Higgins DM, Kerns RD, Brandt CA, Haskell SG, Bathulapalli H, Gilliam W, et al. Persistent pain and comorbidity among operation enduring freedom/operation Iraqi freedom/operation new Dawn veterans. Pain Med. 2014;15(5):782–90.PubMedCrossRef Higgins DM, Kerns RD, Brandt CA, Haskell SG, Bathulapalli H, Gilliam W, et al. Persistent pain and comorbidity among operation enduring freedom/operation Iraqi freedom/operation new Dawn veterans. Pain Med. 2014;15(5):782–90.PubMedCrossRef
62.
go back to reference Higgins D, Buta E, Heapy A, Driscoll M, Kerns R, Masheb R, et al. The relationship among BMI, pain intensity, and musculoskeletal diagnoses. J Pain. 2016;17(4):S28.CrossRef Higgins D, Buta E, Heapy A, Driscoll M, Kerns R, Masheb R, et al. The relationship among BMI, pain intensity, and musculoskeletal diagnoses. J Pain. 2016;17(4):S28.CrossRef
63.
go back to reference Outcalt SD, Ang DC, Wu J, Sargent C, Yu Z, Bair MJ. Pain experience of Iraq and Afghanistan veterans with comorbid chronic pain and posttraumatic stress. J Rehabil Res Dev. 2014;51(4):559–70.PubMedCrossRef Outcalt SD, Ang DC, Wu J, Sargent C, Yu Z, Bair MJ. Pain experience of Iraq and Afghanistan veterans with comorbid chronic pain and posttraumatic stress. J Rehabil Res Dev. 2014;51(4):559–70.PubMedCrossRef
64.
go back to reference •• Buta E, Masheb R, Gueorguieva R, Bathulapalli H, Brandt CA, Goulet JL. Posttraumatic stress disorder diagnosis and gender are associated with accelerated weight gain trajectories in veterans during the post-deployment period. Eat Behav. 2018;29:8–13. A PTSD diagnosis was correlated with higher weight gain trajectories post-deployment in both women and men, with a slightly stronger association in women. Screening and treatment of psychological comorbitity is needed as well as weight management services young Veterans.PubMedPubMedCentralCrossRef •• Buta E, Masheb R, Gueorguieva R, Bathulapalli H, Brandt CA, Goulet JL. Posttraumatic stress disorder diagnosis and gender are associated with accelerated weight gain trajectories in veterans during the post-deployment period. Eat Behav. 2018;29:8–13. A PTSD diagnosis was correlated with higher weight gain trajectories post-deployment in both women and men, with a slightly stronger association in women. Screening and treatment of psychological comorbitity is needed as well as weight management services young Veterans.PubMedPubMedCentralCrossRef
65.
go back to reference Malhotra R, Ostbye T, Riley CM, Finkelstein EA. Young adult weight trajectories through midlife by body mass category. Obesity (Silver Spring). 2013;21(9):1923–34. Malhotra R, Ostbye T, Riley CM, Finkelstein EA. Young adult weight trajectories through midlife by body mass category. Obesity (Silver Spring). 2013;21(9):1923–34.
66.
go back to reference Wallace T, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487–95.PubMedCrossRef Wallace T, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487–95.PubMedCrossRef
67.
go back to reference Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C, National Heart L, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Arterioscler Thromb Vasc Biol. 2004;24(2):e13–8.PubMed Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C, National Heart L, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Arterioscler Thromb Vasc Biol. 2004;24(2):e13–8.PubMed
68.
go back to reference Wolf EJ, Miller DR, Logue MW, Sumner J, Stoop TB, Leritz EC, et al. Contributions of polygenic risk for obesity to PTSD-related metabolic syndrome and cortical thickness. Wolf EJ, Miller DR, Logue MW, Sumner J, Stoop TB, Leritz EC, et al. Contributions of polygenic risk for obesity to PTSD-related metabolic syndrome and cortical thickness.
69.
go back to reference Wolf EJ, Bovin MJ, Green JD, Mitchell KS, Stoop TB, Barretto KM, et al. Longitudinal associations between post-traumatic stress disorder and metabolic syndrome severity. Psychol Med. 2016;46(10):2215–26.PubMedPubMedCentralCrossRef Wolf EJ, Bovin MJ, Green JD, Mitchell KS, Stoop TB, Barretto KM, et al. Longitudinal associations between post-traumatic stress disorder and metabolic syndrome severity. Psychol Med. 2016;46(10):2215–26.PubMedPubMedCentralCrossRef
71.
go back to reference Kilbourne AM, Barbaresso MM, Lai Z, Nord KM, Bramlet M, Goodrich DE, et al. Improving physical health in patients with chronic mental disorders: twelve-month results from a randomized controlled collaborative care trial. J Clin Psychiatry. 2017;78(1):129–37.PubMedPubMedCentralCrossRef Kilbourne AM, Barbaresso MM, Lai Z, Nord KM, Bramlet M, Goodrich DE, et al. Improving physical health in patients with chronic mental disorders: twelve-month results from a randomized controlled collaborative care trial. J Clin Psychiatry. 2017;78(1):129–37.PubMedPubMedCentralCrossRef
72.
go back to reference Pomerantz AS, Sayers SL. Primary care-mental health integration in healthcare in the Department of Veterans Affairs. Fam Syst Health. 2010;28(2):78–82.PubMedCrossRef Pomerantz AS, Sayers SL. Primary care-mental health integration in healthcare in the Department of Veterans Affairs. Fam Syst Health. 2010;28(2):78–82.PubMedCrossRef
73.
go back to reference Guerrero AP, Takesue CL, Medeiros JH, Duran AA, Humphry JW, Lunsford RM, et al. Primary care integration of psychiatric and behavioral health services: a primer for providers and case report of local implementation. Hawaii J Med Public Health. 2017;76(6):147–51.PubMedPubMedCentral Guerrero AP, Takesue CL, Medeiros JH, Duran AA, Humphry JW, Lunsford RM, et al. Primary care integration of psychiatric and behavioral health services: a primer for providers and case report of local implementation. Hawaii J Med Public Health. 2017;76(6):147–51.PubMedPubMedCentral
74.
go back to reference Whitworth JW, Ciccolo JT. Exercise and post-traumatic stress disorder in military veterans: a systematic review. Mil Med. 2016;181(9):953–60.PubMedCrossRef Whitworth JW, Ciccolo JT. Exercise and post-traumatic stress disorder in military veterans: a systematic review. Mil Med. 2016;181(9):953–60.PubMedCrossRef
75.
go back to reference Goldstein LA, Mehling WE, Metzler TJ, Cohen BE, Barnes DE, Choucroun GJ, et al. Veterans group exercise: a randomized pilot trial of an integrative exercise program for veterans with posttraumatic stress. J Affect Disord. 2018;227:345–52.PubMedCrossRef Goldstein LA, Mehling WE, Metzler TJ, Cohen BE, Barnes DE, Choucroun GJ, et al. Veterans group exercise: a randomized pilot trial of an integrative exercise program for veterans with posttraumatic stress. J Affect Disord. 2018;227:345–52.PubMedCrossRef
77.
go back to reference Moin T, Damschroder LJ, AuYoung M, Maciejewski ML, Datta SK, Weinreb JE, et al. Diabetes prevention program translation in the veterans health administration. Am J Prev Med. 2017;53(1):70–7.PubMedPubMedCentralCrossRef Moin T, Damschroder LJ, AuYoung M, Maciejewski ML, Datta SK, Weinreb JE, et al. Diabetes prevention program translation in the veterans health administration. Am J Prev Med. 2017;53(1):70–7.PubMedPubMedCentralCrossRef
78.
go back to reference Maciejewski ML, Shepherd-Banigan M, Raffa SD, Weidenbacher HJ. Systematic review of behavioral weight management program MOVE! For veterans. Am J Prev Med. 2018;54(5):704–14.PubMedCrossRef Maciejewski ML, Shepherd-Banigan M, Raffa SD, Weidenbacher HJ. Systematic review of behavioral weight management program MOVE! For veterans. Am J Prev Med. 2018;54(5):704–14.PubMedCrossRef
79.
go back to reference Kahwati LC, Lewis MA, Kane H, Williams PA, Nerz P, Jones KR, et al. Best practices in the veterans health Administration's MOVE! Weight management program. Am J Prev Med. 2011;41(5):457–64.PubMedCrossRef Kahwati LC, Lewis MA, Kane H, Williams PA, Nerz P, Jones KR, et al. Best practices in the veterans health Administration's MOVE! Weight management program. Am J Prev Med. 2011;41(5):457–64.PubMedCrossRef
80.
go back to reference Maguen S, Hoerster KD, Littman AJ, Klingaman EA, Evans-Hudnall G, Holleman R, et al. Iraq and Afghanistan veterans with PTSD participate less in VA's weight loss program than those without PTSD. J Affect Disord. 2016;193:289–94.PubMedCrossRef Maguen S, Hoerster KD, Littman AJ, Klingaman EA, Evans-Hudnall G, Holleman R, et al. Iraq and Afghanistan veterans with PTSD participate less in VA's weight loss program than those without PTSD. J Affect Disord. 2016;193:289–94.PubMedCrossRef
81.
go back to reference Skoyen JA, Rutledge T, Wiese JA, Woods GN. Evaluation of TeleMOVE: a Telehealth Weight Reduction Intervention for Veterans with Obesity. Ann Behav Med. 2015;49(4):628–33.PubMedCrossRef Skoyen JA, Rutledge T, Wiese JA, Woods GN. Evaluation of TeleMOVE: a Telehealth Weight Reduction Intervention for Veterans with Obesity. Ann Behav Med. 2015;49(4):628–33.PubMedCrossRef
82.
go back to reference Rutledge T, Skoyen JA, Wiese JA, Ober KM, Woods GN. A comparison of MOVE! Versus TeleMOVE programs for weight loss in veterans with obesity. Obes Res Clin Pract. 2017;11(3):344–51.PubMedCrossRef Rutledge T, Skoyen JA, Wiese JA, Ober KM, Woods GN. A comparison of MOVE! Versus TeleMOVE programs for weight loss in veterans with obesity. Obes Res Clin Pract. 2017;11(3):344–51.PubMedCrossRef
83.
go back to reference Goodrich DE, Lowery JC, Burns JA, Richardson CR. The phased implementation of a National Telehealth Weight Management Program for veterans: mixed-methods program evaluation. JMIR Diabetes. 2018;3(3):e14.PubMedPubMedCentralCrossRef Goodrich DE, Lowery JC, Burns JA, Richardson CR. The phased implementation of a National Telehealth Weight Management Program for veterans: mixed-methods program evaluation. JMIR Diabetes. 2018;3(3):e14.PubMedPubMedCentralCrossRef
84.
go back to reference Weingardt KR, Greene CJ. New electronic tools for veterans. N C Med J. 2015;76(5):332–4.PubMed Weingardt KR, Greene CJ. New electronic tools for veterans. N C Med J. 2015;76(5):332–4.PubMed
Metadata
Title
Risk Factors of Obesity in Veterans of Recent Conflicts: Need for Diabetes Prevention
Authors
Dora Lendvai Wischik
Cherlie Magny-Normilus
Robin Whittemore
Publication date
01-09-2019
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 9/2019
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-019-1191-9

Other articles of this Issue 9/2019

Current Diabetes Reports 9/2019 Go to the issue

Pathogenesis of Type 2 Diabetes and Insulin Resistance (M-E Patti, Section Editor)

Regulation of Glucose Production in the Pathogenesis of Type 2 Diabetes

Microvascular Complications—Retinopathy (DL Chao and G Yiu, Section Editors)

Artificial Intelligence Screening for Diabetic Retinopathy: the Real-World Emerging Application

Microvascular Complications—Retinopathy (DL Chao and G Yiu, Section Editors)

Scaling Up Teleophthalmology for Diabetic Eye Screening: Opportunities for Widespread Implementation in the USA

Diabetes and Pregnancy (M-F Hivert and CE Powe, Section Editors)

Exercise in Pregnant Women with Diabetes

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine