Survivors

How war vets—and the rest of us—heal from trauma

Does Trauma While In the Military Make You Fat?

The prevalence of obesity is on the rise, even among military personnel.

Are individuals who served in the military more likely to become overweight and obese? There is some evidence to suggest yes. Studies suggest that when compared to civilians, persons who served in the Armed Forces may be slightly more likely to become obese.   

Rates of obesity are also higher when comparing our veterans who utilize VA services as compared to veterans not in the VA system. These veterans are more likely to have poor health, including hypertension, diabetes and PTSD.

So why would service in the military be associated with higher rates of obesity? Let’s break some potential hypotheses. 

1. Diet/exercise: The simplest equation of weight management involves math (calories in, energy out). In other words, diet and exercise. Some people might think that individuals trained in the military have rigid diet and exercise routines. Therefore, individuals in the military are in a better position to regulate their weight. During their time in the service, food is regulated by the branch they are in. Fitness is mandatory. In fact, people are flagged when they do not perform well on fitness tests. One might think that being in the military teaches individuals to regulate diet and exercise activities. 

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I’ve heard three different things regarding diet and exercise during and post-military.

a) DURING MILITARY SERVICE: I’ve heard that maintaining a healthy diet while in the military is not easy.  And it’s particularly hard to eat healthy during intense trainings and during deployments. 

b) POST SERVICE: Food and exercise is one of the few things that can be controlled and therefore some individuals become very regulated with their diet and exercise.  

c) POST SERVICE: Food and exercise is one of the few things that can be controlled and therefore some individuals become very excessive in their food intake and cease all exercise activities.

Based on what I’ve heard from individuals, being in the military may help some individuals maintain an active exercise regimen while in the service. This may or may not lead to a healthy active lifestyle after service. We may also be able to glean that being in the military does not help individuals learn healthy eating habits. 

2. Physical health: One of the most frequently diagnosed conditions within the VA system among returning veterans from the wars in Iraq and Afghanistan is pain associated with a musculoskeletal injury. Being in the military can get you hurt. And, of course, injury impacts the ability to engage in certain types of exercise, depending on the nature and extent of the injury. 

A change in physical health can impact psychological health. Individuals who have a job that depends on their physical health (such as members of the military, police officers, fire fighters, professional athletes, etc.) have to adjust to the potential loss of their career when injured. This can lead to feelings of sadness and the loss of hope, which may further exacerbate the experience of pain.  

Physical health would be further compromised if it leads to weight gain. There are multiple health related conditions associated with being overweight (i.e., hypertension and diabetes). And these would lead to increased difficulties maintaining a healthy lifestyle and weight maintenance. 

3. Trauma: Three categories of symptoms are associated with trauma and suffering from posttraumatic stress disorder. These are: a) re-experiencing (having nightmares or flashbacks); b) avoidance (avoiding stimuli related to the traumatic event); and c) hyper-arousal (agitation, sleeping difficulties). Overeating may be considered a symptom of hyper-arousal. Many people recover from a traumatic event by isolating and decreasing the amount of time spent outside engaging in fun activities. And many indicate that they tend to spend their time around the house eating and gaining weight. I work with returning service members struggling with PTSD and I have repeatedly heard about rapid and excessive weight gain after separating from the service.

It’s hard to pick out just one story to demonstrate this point, but one particular fellow pops into my mind when I think of weight gain after discharging from the military.  This fellow returned from his deployment to Iraq and had considerable difficulties relaxing. He was so agitated from memories of a traumatic event that he began to rely on substances to help calm him down. His substance use escalated when he decided to work in a club in the town he lived in and was surrounded by individuals using alcohol and drugs. One evening, he got involved with a female who worked at the club and was accused of sexual assault. He lost his position at work and went through legal proceedings. He was found guilty of assault and is required by law to have regular drug and alcohol screenings. He has not looked for a job for over a year. He states that he spends his time in his home. Eating. He indicated that he has gained 100 pounds since the incident. He is married, and although his marriage has been strained, he reports that he and his wife would like to stay together. 

This story demonstrates the power trauma can have on an individual. In essence, person A experiences a traumatic incident, person A wants to avoid memories of incident and decides to use drugs and alcohol to numb self, drugs and alcohol create opportunities for trouble, trouble happens, main coping skill of using drugs and alcohol limited, new coping skills must be immediately implemented and practiced (and effective). It is unlikely that person A will be able to effectively manage the stress of the initial trauma and the subsequent trouble, when they were relying on alcohol and drugs to manage symptoms from the initial trauma.  Individuals who tend to use one or two primary coping skills (even if these skills are considered healthy like exercise or cleaning or organizing) will get in trouble if they do not open themselves up to multiple methods of coping. And support.  

In summary, being in the military has recently been associated with an increased likelihood of becoming overweight and/or obese. There may be practical reasons why this could be true, although more research is clearly needed to determine the incidence and causes of obesity among military populations. 

Tracy Stecker, Ph.D., is an Assistant Professor at the Psychiatric Research Center in the Department of Community and Family Medicine at Dartmouth Medical School.

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