Jeffrey F Scherrer1, Joanne Salas2, Kathleen M Chard3, Peter Tuerk4, Carissa van den Berk-Clark5, F David Schneider6, Beth E Cohen7, Patrick J Lustman8, Paula P Schnurr9, Matthew J Friedman9, Sonya B Norman10. 1. Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, United States; Harry S. Truman Veterans Administration Medical Center, Columbia, MO, United States. Electronic address: jeffrey.scherrer@health.slu.edu. 2. Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, United States; Harry S. Truman Veterans Administration Medical Center, Columbia, MO, United States. 3. Trauma Recovery Center Cincinnati VAMC, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, United States. 4. Sheila C. Johnson Center for Clinical Services, Department of Human Services, University of Virginia, Charlottesville, VA, United States. 5. Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, United States. 6. Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States. 7. Department of Medicine, University of California San Francisco School of Medicine and San Francisco VAMC, United States. 8. Department of Psychiatry, Washington University School of Medicine, St. Louis MO. and The Bell Street Clinic Opioid Addiction Treatment Programs, VA St. Louis Healthcare System, St. Louis, MO, United States. 9. National Center for PTSD and Department of Psychiatry, Geisel School of Medicine at Dartmouth, United States. 10. National Center for PTSD and Department of Psychiatry, University of California San Diego, United States.
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.
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.
Authors: Erin L O'Hea; Edwin D Boudreaux; Shawn K Jeffries; Cindy L Carmack Taylor; Isabel C Scarinci; Phillip J Brantley Journal: Am J Health Promot Date: 2004 Nov-Dec
Authors: Jeffrey F Scherrer; Joanne Salas; James S Floyd; Susan A Farr; John E Morley; Sascha Dublin Journal: Mayo Clin Proc Date: 2019-08 Impact factor: 7.616
Authors: Shira Maguen; Katherine D Hoerster; Alyson J Littman; Elizabeth A Klingaman; Gina Evans-Hudnall; Rob Holleman; H Myra Kim; David E Goodrich Journal: J Affect Disord Date: 2016-01-06 Impact factor: 4.839
Authors: Patricia A Resick; Jennifer Schuster Wachen; Katherine A Dondanville; Kristi E Pruiksma; Jeffrey S Yarvis; Alan L Peterson; Jim Mintz; Elisa V Borah; Antoinette Brundige; Elizabeth A Hembree; Brett T Litz; John D Roache; Stacey Young-McCaughan Journal: JAMA Psychiatry Date: 2017-01-01 Impact factor: 21.596
Authors: Joanne Salas; Sarah Gebauer; Auston Gillis; Carissa van den Berk-Clark; F David Schneider; Paula P Schnurr; Matthew J Friedman; Sonya B Norman; Peter W Tuerk; Beth E Cohen; Patrick J Lustman; Jeffrey F Scherrer Journal: Nicotine Tob Res Date: 2022-02-01 Impact factor: 5.825