Women suffering from post-traumatic stress disorder (PTSD) are at greater risk for becoming overweight or obese, according to the latest results from the Nurses Health Study.

The study, published in JAMA Psychiatry, show that women of normal weight who developed PTSD symptoms during the study period had a 36 percent increased risk for becoming overweight compared with women who experienced trauma with no PTSD symptoms.

“PTSD is not just a mental health issue. Along with cardiovascular disease and diabetes, we can now add obesity to the list of known health risks of PTSD,” said senior author Karestan Koenen, Ph.D., Mailman School of Public Health of Columbia University in New York City.

Researchers said that this is the first longitudinal study to look at the relationship between PTSD and obesity.

“This study is the first to examine the prospective relation of PTSD symptoms to BMI [body mass index] trajectories and obesity in women exposed to a wide range of traumatic events occurring in civilian settings,” they write.

For the study, the researchers analyzed data from a subsample of the Nurses Health Study II, which included 54,224 participants aged 22 to 44 years in 1989 in which they measured trauma and PTSD symptoms. Participants were followed up until 2005.

PTSD was defined as having four or more symptoms during a period of 1 month or longer. Common symptoms included re-experiencing the traumatic event, feeling under threat, and social avoidance.

The findings showed that the onset of at least four PTSD symptoms in 1989 was linked to an increased risk of becoming overweight or obese among women with normal BMI in 1989.

The higher risk was marked even for women with subthreshold symptom levels, and the risk remained after adjusting for depression, which is also considered a major risk factor for obesity.

The researchers note that the effects of PTSD on women’s weight may be even greater in the general population.

“Nurses are great for studies because they report health measures like BMI with a high degree of accuracy. But they are also more health conscious and probably less likely to become obese than most of us, which makes these results more conservative than they would otherwise be,” said Koenen.

The researchers suspect that PTSD may affect weight gain through simultaneous biological and behavioral mechanisms, including unhealthy lifestyle behaviors, such as physical inactivity and consumption of junk food, and dysregulated neuroendocrine function.

Furthermore, the findings suggest that women with PTSD should be monitored or undergo screening for poor cardiometabolic outcomes.

The researchers suggest that PTSD treatment should be broadened to include such measures as diet and exercise to help ease the risk for obesity. They point out that currently, “health behaviors are completely outside the scope of PTSD treatments.”

This article first appeared on Psych Central on 30 November, 2013.