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Mental Health and Obesity Among Veterans: A Possible Need for Integrated Care
Jessica Y Breland1, Susan M Frayne1, Christine Timko1
1U.S. Department of Veterans Affairs (VA) Health Services Research & Development (HSR&D) Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California (Breland, Frayne, Timko); Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California (Frayne); Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford (Timko); VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles (Washington); Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (Washington); San Francisco VA Health Care System, San Francisco, and Department of Psychiatry, University of California, San Francisco (Maguen).
Objective:
The goal was to examine psychiatric diagnosis rates among a national cohort of primary care patients with and without obesity.
Methods:
The cohort was derived from national Veterans Health Administration data (women, N=342,262; men, N=4,524,787). Sex-stratified descriptive statistics characterized psychiatric diagnosis rates. Chi-square tests determined whether diagnosis rates differed by obesity status (α=0.001).
Results:
Rates of any psychiatric diagnosis were higher among women than among men and among people with obesity versus without obesity (women, 53.9% vs. 50.4%; men, 37.9% vs. 35.2%). Depression and posttraumatic stress disorder diagnosis rates were higher for people with obesity, and substance use disorder diagnosis rates were lower for people with obesity. Anxiety diagnosis rates were slightly lower among women with obesity versus women without obesity.
Conclusions:
Programs simultaneously addressing weight management and mental health could address the psychiatric comorbidities observed among people with obesity. Women are most likely to need these services.
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