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Post-traumatic stress disorder and the association with overweight, obesity, and weight change among individuals exposed to the World Trade Center disaster, 2003–2016

Published online by Cambridge University Press:  07 May 2020

Erin Takemoto*
Department of Health & Mental Hygiene, World Trade Center Health Registry, 30-30 47th Ave, Suite 414, Long Island City, NY11101, USA
Katherine R. Van Oss
Department of Health & Mental Hygiene, Center for Health Equity and Community Wellness, 42-09 28th St., Long Island City, NY11101, USA
Shadi Chamany
Department of Health & Mental Hygiene, Center for Health Equity and Community Wellness, 42-09 28th St., Long Island City, NY11101, USA
Jennifer Brite
Department of Health & Mental Hygiene, World Trade Center Health Registry, 30-30 47th Ave, Suite 414, Long Island City, NY11101, USA
Robert Brackbill
Department of Health & Mental Hygiene, World Trade Center Health Registry, 30-30 47th Ave, Suite 414, Long Island City, NY11101, USA
Author for correspondence: Erin Takemoto, E-mail:



Among Veterans, post-traumatic stress disorder (PTSD) has been shown to be associated with obesity and accelerated weight gain. Less is known among the general population. We sought to determine the impact of PTSD on body mass index (BMI) and weight change among individuals with exposure to the World Trade Center (WTC) disaster.


We examined individuals from the WTC Health Registry. PTSD symptoms were assessed on multiple surveys (Waves 1–4) using the PTSD Checklist-Specific. Three categories of post-9/11 PTSD were derived: no, intermittent, and persistent. We examined two outcomes: (1) Wave 3 BMI (normal, overweight, and obese) and (2) weight change between Waves 3 and 4. We used multivariable logistic regression to assess the association between PTSD and BMI (N = 34 958) and generalized estimating equations to assess the impact of PTSD on weight change (N = 26 532). Sex- and age-stratified analyses were adjusted for a priori confounders.


At Wave 3, the observed prevalence of obesity was highest among the persistent (39.5%) and intermittent PTSD (36.6%) groups, compared to the no PTSD group (29.3%). In adjusted models, persistent and intermittent PTSD were consistently associated with a higher odds of obesity. Weight gain was similar across all groups, but those with persistent and intermittent PTSD had higher estimated group-specific mean weights across time.


Our findings that those with a history of PTSD post-9/11 were more likely to have obesity is consistent with existing literature. These findings reaffirm the need for an interdisciplinary focus on physical and mental health to improve health outcomes.

Original Article
Copyright © The Author(s), 2020. Published by Cambridge University Press

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