Trauma, Obesity, and Ghrelin

New studies suggest that trauma, obesity, and ghrelin may interact to provide yet another biological pathway for obesity. Clinicians will tell you that traumatic stress, such as sexual abuse, can be an important risk factor for obesity. Now researchers at the Harvard School of Public Health have documented that symptoms of post-traumatic stress disorder (PTSD) lead to a more rapid rise in BMI and the development of obesity in women. And animal studies are showing that the hunger-regulating hormone ghrelin may play a role in the response to traumatic stress and the development of PTSD.

Laura D. Kubzansky and colleagues analyzed data from 54,224 women in the Nurses Health Study II to evaluate whether women who developed PTSD were more likely to subsequently develop obesity. They found both an increased risk of developing obesity and an accelerated rate of increase in BMI subsequent to the development of PTSD symptoms. Kubzansky noted:

Physicians may be more effective if they can recognize and manage this type of emotional distress. Our work may also suggest that women with PTSD should be monitored or undergo screening for development of adverse cardiometabolic outcomes. In fact, our work highlights the importance of expanding PTSD treatments to attend to behavioral alterations — such as changes in diet or exercise — that lead to obesity.

Providing further insight is a series of animal studies from MIT that document an interaction between ghrelin, traumatic stress, and growth hormone in the brain’s amygdala in response to traumatic stress. They found that elevated ghrelin levels in chronic fear and stress as experienced in PTSD interacted with growth hormone to reinforce fearsome memories. This animal research, published in Molecular Psychiatry, suggests a complex relationship between PTSD, ghrelin, and obesity.

If we can better understand the neuroscience linking PTSD and obesity, important advances for treatment in this substantial subset of people with obesity will result.

Click here to read more about PTSD and obesity in the LA Times and here to read the study. Click here to read more about ghrelin and PTSD in the MIT Technology Review, and here to read the study.

Far Behind, photograph © Lauren Rushing / flickr

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