Monday, January 12, 2009

Real Primary Prevention - Obesity Causes Disease, but What Causes Obesity?

Am J Prev Med Volume 36, Issue 1, Pages 1-8 (January 2009)
Posttraumatic Stress Disorder and Obesity: Evidence for a Risk Association
Axel Perkonigg, PhDac, Toshimi Owashi, MDcd, Murray B. Stein, MD, MPHe, Clemens Kirschbaum, PhDb, Hans-Ulrich Wittchen, PhDac
published online 03 November 2008.
There is evidence from cross-sectional studies that posttraumatic stress disorder (PTSD) may be associated with obesity. The aim of this study was to examine prospective longitudinal associations between PTSD and obesity in a community sample.
A prospective, longitudinal, epidemiologic study with a representative community sample of adolescents and young adults (N=3021, aged 14–24 years at baseline) was conducted in Munich, Germany. Participants were assessed four times between 1995 and 2005 with the Munich-Composite International Diagnostic Interview. Associations between obesity (BMI ≥30) and DSM-IV PTSD were evaluated in 2007, using cross-sectional and prospective data during young adulthood.
The cumulative lifetime incidence of obesity in the sample at 10-year follow-up during young adulthood was 4.3% (women, 4.6%; men, 4.0%). Among women but not among men, obesity was associated with a lifetime history of PTSD (OR=3.8; 95% CI=1.4, 10.7) in the cross-sectional analyses. Prospective longitudinal analyses from 4-year follow-up to 10-year follow-up confirmed that obesity was predicted by antecedent subthreshold and full PTSD (OR=3.0; 95% CI=1.3, 7.0) among women but not among men. There were no associations between other mental disorders and obesity in the prospective analyses.
The findings indicate a possible causal pathway for the onset of obesity in females with PTSD symptoms. These findings need replication with regard to the pathophysiologic and behavioral mechanisms underlying this relationship."
BrooklynDodger(s) comment: This publication adds to the framework asserting that "pain," broadly defined, causes health risk behavior, by this mechanism causing adverse intermediate conditions (obesity) leading to adverse outcomes. This publication finds an association between PTSD and later obesity among women but not men. The absence of an association among men - who suffered an equivalent incidence of obesity - might be explained by the greater prevalence of other stressors among men. This is clearly culturally defined by Munich.

The literature about obsesity and adverse effects is suffused with the odor of moral panic and victim blaming. Another post sometime will address this.

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