PTSD symptom decrease and use of weight loss programs

Jeffrey F. Scherrer, Joanne Salas, Kathleen M. Chard, Peter Tuerk, Carissa van den Berk-Clark, F. David Schneider, Beth E. Cohen, Patrick J. Lustman, Paula P. Schnurr, Matthew J. Friedman, Sonya B. Norman

Research output: Contribution to journalArticle

Abstract

Objective: Posttraumatic stress disorder (PTSD) is associated with poor health behaviors, including low utilization of Veteran Health Affairs (VHA) weight loss programs. It is not known if clinically meaningful PTSD improvement is associated with increased use of weight loss programs. Methods: Medical record data was obtained from VHA patients who received PTSD specialty care between Fiscal Year (FY) 2008 to FY2012. Clinically meaningful PTSD improvement was defined as ≥20 point PTSD Checklist (PCL) decrease between the first PCL ≥ 50 and a second PCL at least 8 weeks later and within 12 months of the first PCL. Eligible patients, n = 993, were followed through FY2015. Propensity scores and inverse probability of exposure weighting controlled confounding. Cox proportional hazard models estimated the association between clinically meaningful PCL decrease and weight loss clinic utilization. Supplemental analysis compared both PTSD groups vs. no PTSD. Results: Patients were 44.8 (SD ±14) years of age, 88.9% male and 66.8% white. Patients with vs. without a clinically meaningful PCL decrease were more likely to use a weight loss clinic (HR = 1.37; 95%CI:1.02–1.85). Among those with a weight loss encounter, PCL decrease was not associated with the number of encounters (RR = 1.13; 95%CI:0.70–1.81). Compared to no PTSD, patients with PTSD improvement had more weight loss encounters. Conclusions: Large improvements in PTSD are associated with increased utilization of weight loss programs, and PTSD is not a barrier to seeking weight loss counseling. Research to understand why improvement in PTSD is not related to better weight loss outcomes is needed.

Original languageEnglish (US)
Article number109849
JournalJournal of Psychosomatic Research
Volume127
DOIs
StatePublished - Dec 2019

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Weight Reduction Programs
Post-Traumatic Stress Disorders
Checklist
Weight Loss
Veterans Health
Propensity Score

Keywords

  • Cohort
  • Epidemiology
  • Health services
  • Nutrition
  • Posttraumatic stress disorder
  • Veteran
  • Weight

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Scherrer, J. F., Salas, J., Chard, K. M., Tuerk, P., van den Berk-Clark, C., Schneider, F. D., ... Norman, S. B. (2019). PTSD symptom decrease and use of weight loss programs. Journal of Psychosomatic Research, 127, [109849]. https://doi.org/10.1016/j.jpsychores.2019.109849

PTSD symptom decrease and use of weight loss programs. / Scherrer, Jeffrey F.; Salas, Joanne; Chard, Kathleen M.; Tuerk, Peter; van den Berk-Clark, Carissa; Schneider, F. David; Cohen, Beth E.; Lustman, Patrick J.; Schnurr, Paula P.; Friedman, Matthew J.; Norman, Sonya B.

In: Journal of Psychosomatic Research, Vol. 127, 109849, 12.2019.

Research output: Contribution to journalArticle

Scherrer, JF, Salas, J, Chard, KM, Tuerk, P, van den Berk-Clark, C, Schneider, FD, Cohen, BE, Lustman, PJ, Schnurr, PP, Friedman, MJ & Norman, SB 2019, 'PTSD symptom decrease and use of weight loss programs', Journal of Psychosomatic Research, vol. 127, 109849. https://doi.org/10.1016/j.jpsychores.2019.109849
Scherrer, Jeffrey F. ; Salas, Joanne ; Chard, Kathleen M. ; Tuerk, Peter ; van den Berk-Clark, Carissa ; Schneider, F. David ; Cohen, Beth E. ; Lustman, Patrick J. ; Schnurr, Paula P. ; Friedman, Matthew J. ; Norman, Sonya B. / PTSD symptom decrease and use of weight loss programs. In: Journal of Psychosomatic Research. 2019 ; Vol. 127.
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abstract = "Objective: Posttraumatic stress disorder (PTSD) is associated with poor health behaviors, including low utilization of Veteran Health Affairs (VHA) weight loss programs. It is not known if clinically meaningful PTSD improvement is associated with increased use of weight loss programs. Methods: Medical record data was obtained from VHA patients who received PTSD specialty care between Fiscal Year (FY) 2008 to FY2012. Clinically meaningful PTSD improvement was defined as ≥20 point PTSD Checklist (PCL) decrease between the first PCL ≥ 50 and a second PCL at least 8 weeks later and within 12 months of the first PCL. Eligible patients, n = 993, were followed through FY2015. Propensity scores and inverse probability of exposure weighting controlled confounding. Cox proportional hazard models estimated the association between clinically meaningful PCL decrease and weight loss clinic utilization. Supplemental analysis compared both PTSD groups vs. no PTSD. Results: Patients were 44.8 (SD ±14) years of age, 88.9{\%} male and 66.8{\%} white. Patients with vs. without a clinically meaningful PCL decrease were more likely to use a weight loss clinic (HR = 1.37; 95{\%}CI:1.02–1.85). Among those with a weight loss encounter, PCL decrease was not associated with the number of encounters (RR = 1.13; 95{\%}CI:0.70–1.81). Compared to no PTSD, patients with PTSD improvement had more weight loss encounters. Conclusions: Large improvements in PTSD are associated with increased utilization of weight loss programs, and PTSD is not a barrier to seeking weight loss counseling. Research to understand why improvement in PTSD is not related to better weight loss outcomes is needed.",
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AU - Schneider, F. David

AU - Cohen, Beth E.

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AU - Norman, Sonya B.

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