BMI trajectory groups in veterans of the Iraq and Afghanistan wars

The study sought to determine BMI trajectories in Iraq/Afghanistan veterans over 6 years and to examine sociodemographic factors associated with BMI trajectory membership.

Our study sample included 16,656 veterans post-deployment and entering the Veteran Healthcare Administration (VHA) healthcare system. We used national VHA administrative sociodemographic data, tracked veteran BMI for 6 years, and used trajectory modeling to identify BMI trajectories and sociodemographic characteristics associated with trajectory membership.

Five trajectory groups determined in the full sample were primarily differentiated by their post-deployment initial BMI: "healthy" (14.1%), "overweight" (36.3%), "borderline obese" (27.9%), "obese" (15.7%), and "severely obese" (6.0). Being female, younger, and white were associated with lower initial BMI trajectory group membership (p's<.05). Greater observed BMI increase was associated with higher initial BMI across groups (0.6, 0.8, 1.5, 1.9, 2.7). Gender specific trajectory models found that male Veterans with higher education and white female Veterans were associated with the lowest initial BMI group (p's<.05).

Higher post-deployment BMI was associated with greater BMI gain over time for both male and female veterans. Older age is associated with higher BMI regardless of gender. Education level and racial status are differentially related to BMI trajectory by gender.