{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T16:35:29Z","timestamp":1769272529804,"version":"3.49.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1-2","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To assess whether abnormal body mass index (BMI) among Israeli Defense Force (IDF) recruits is associated with increased risk for post-traumatic stress disorder (PTSD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 1,430,118 Israeli late adolescents aged 16\u201320 who were physically and mentally evaluated before IDF enlistment from January 1, 1998, to December 31, 2019. Body mass index was measured before enlistment, and PTSD diagnoses were based on the DSM-5 criteria as recorded by the IDF or the Ministry of Defense for combat-related PTSD. Individuals with PTSD diagnosis before recruitment were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 1,430,118 late adolescents in this study, 839,200 (58.7%) were male, 1,329,796 (93.1%) were Jewish, and 392,418 (27.5%) served in combat roles. Post-traumatic stress disorder was diagnosed in 7,157 (0.5%) individuals. No significant association was found between BMI and PTSD risk in combat setting. However, late adolescents with prior psychiatric diagnoses exhibited an elevated PTSD risk: 40% higher in combatants (odds ratio [OR]\u2009=\u20091.366) and 30% higher in non-combatants (OR\u2009=\u20091.296). Furthermore, extreme BMI values (below 17 or above 35) in non-combat roles were associated with a lower PTSD risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the largest cohort study to date on the association between BMI and PTSD because of combat, BMI did not significantly predict PTSD risk in combat-exposed soldiers, while psychiatric history emerged as a stronger predictor across all military roles. These findings suggest prioritizing mental health history over BMI in PTSD risk assessment and prevention efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaf334","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T07:51:05Z","timestamp":1749801065000},"page":"e267-e274","source":"Crossref","is-referenced-by-count":0,"title":["Body Mass Index and Risk of Post-Traumatic Stress Disorder: A Cohort Study of 1.4 Million Late Adolescents"],"prefix":"10.1093","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0007-6238","authenticated-orcid":false,"given":"Shlomi","family":"Abuhasira","sequence":"first","affiliation":[{"name":"Medical Corps, Israel Defense Forces , Ramat Gan 5262000,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4727-4474","authenticated-orcid":false,"given":"Lucian","family":"Tatsa-Laur","sequence":"additional","affiliation":[{"name":"Medical Corps, Israel Defense Forces , Ramat Gan 5262000,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0611-137X","authenticated-orcid":false,"given":"Leah","family":"Shelef","sequence":"additional","affiliation":[{"name":"Medical Corps, Israel Defense Forces , Ramat Gan 5262000,","place":["Israel"]},{"name":"The School of Social Work, Sapir Academic College , D. N. Hof Ashkelon 79165,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"2026012303275070700_usaf334-B1","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1002\/wps.20656","article-title":"Post-traumatic stress disorder: a state-of-the-art review of evidence and challenges","volume":"18","author":"Bryant","year":"2019","journal-title":"World Psychiatry"},{"key":"2026012303275070700_usaf334-B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000354910","article-title":"Posttraumatic stress disorder and cardiometabolic disease","volume":"127","author":"Levine","year":"2014","journal-title":"Cardiology"},{"key":"2026012303275070700_usaf334-B3","doi-asserted-by":"publisher","first-page":"2459","DOI":"10.1056\/NEJMra1612499","article-title":"Post-traumatic stress disorder","volume":"376","author":"Shalev","year":"2017","journal-title":"N Engl J Med"},{"key":"2026012303275070700_usaf334-B4","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2013","edition":"5th ed"},{"key":"2026012303275070700_usaf334-B5","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1002\/da.22169","article-title":"Cumulative traumas and risk thresholds: 12-month PTSD in the World Mental Health (WMH) surveys","volume":"31","author":"Karam","year":"2014","journal-title":"Depress Anxiety"},{"key":"2026012303275070700_usaf334-B6","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1002\/jts.20646","article-title":"Deployment stressors and outcomes among Air Force chaplains","volume":"24","author":"Levy","year":"2011","journal-title":"J Trauma Stress"},{"key":"2026012303275070700_usaf334-B7","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.1287\/mnsc.1090.1042","article-title":"A dynamic model for posttraumatic stress disorder among U.S. Troops in Operation Iraqi Freedom","volume":"55","author":"Atkinson","year":"2009","journal-title":"Manage Sci"},{"key":"2026012303275070700_usaf334-B8","doi-asserted-by":"publisher","first-page":"520","DOI":"10.7556\/jaoa.2010.110.9.520","article-title":"Combat-related mental health disorders: the case for resiliency in the long war","volume":"110","author":"Callahan","year":"2010","journal-title":"J Am Osteopath Assoc"},{"key":"2026012303275070700_usaf334-B9","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1016\/j.janxdis.2010.11.010","article-title":"Prevalence and axis I comorbidity of full and partial posttraumatic stress disorder in the United States: results from wave 2 of the national epidemiologic survey on alcohol and related conditions","volume":"25","author":"Pietrzak","year":"2011","journal-title":"J Anxiety Disord"},{"key":"2026012303275070700_usaf334-B10","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1002\/jts.21690","article-title":"Posttraumatic stress disorder, substance use disorders, and medical comorbidity among returning U.S. veterans","volume":"25","author":"Nazarian","year":"2012","journal-title":"J Trauma Stress"},{"key":"2026012303275070700_usaf334-B11","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/S1008-1275(08)60044-9","article-title":"Posttraumatic stress and immune dissonance","volume":"11","author":"Jiang","year":"2008","journal-title":"Chinese J Traumatol"},{"key":"2026012303275070700_usaf334-B12","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/S0006-3223(98)00131-0","article-title":"Elevated serum interleukin-6 (IL-6) and IL-6 receptor concentrations in posttraumatic stress disorder following accidental man-made traumatic events","volume":"45","author":"Maes","year":"1999","journal-title":"Biol Psychiatry"},{"key":"2026012303275070700_usaf334-B13","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1038\/ijo.2011.65","article-title":"Body mass index and common mental disorders: exploring the shape of the association and its moderation by age, gender and education","volume":"36","author":"McCrea","year":"2012","journal-title":"Int J Obes (Lond)"},{"key":"2026012303275070700_usaf334-B14","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1001\/jamapsychiatry.2013.4374","article-title":"Assessment of plasma C-reactive protein as a biomarker of posttraumatic stress disorder risk","volume":"71","author":"Eraly","year":"2014","journal-title":"JAMA Psychiatry"},{"key":"2026012303275070700_usaf334-B15","doi-asserted-by":"publisher","first-page":"10.4088\/PCC.15r01848","DOI":"10.4088\/PCC.15r01848","article-title":"A review of posttraumatic stress disorder and obesity: exploring the link","volume":"18","author":"Masodkar","year":"2016","journal-title":"Prim Care Companion CNS Disord"},{"key":"2026012303275070700_usaf334-B16","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1016\/j.metabol.2014.08.009","article-title":"Stress- and PTSD-associated obesity and metabolic dysfunction: a growing problem requiring further research and novel treatments","volume":"63","author":"Farr","year":"2014","journal-title":"Metabolism"},{"key":"2026012303275070700_usaf334-B17","doi-asserted-by":"publisher","first-page":"2215","DOI":"10.1017\/S0033291716000817","article-title":"Longitudinal associations between post-traumatic stress disorder and metabolic syndrome sev\u00aderity","volume":"46","author":"Wolf","year":"2016","journal-title":"Psychol Med"},{"key":"2026012303275070700_usaf334-B18","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1002\/ijop.13231","article-title":"Occupational rehabilitation of Israel Defense Forces veterans with PTSD: a 5-year follow-up","volume":"59","author":"Segev","year":"2024","journal-title":"Int J Psychol"},{"key":"2026012303275070700_usaf334-B19","doi-asserted-by":"publisher","first-page":"E108","DOI":"10.1542\/peds.108.6.e108","article-title":"Comparison of body weight and height of Israeli schoolchildren with the Tanner and Centers for Disease Control and Prevention growth charts","volume":"108","author":"Goldstein","year":"2001","journal-title":"Pediatrics"},{"key":"2026012303275070700_usaf334-B20","doi-asserted-by":"publisher","first-page":"2430","DOI":"10.1056\/NEJMoa1503840","article-title":"Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood","volume":"374","author":"Twig","year":"2016","journal-title":"N Engl J Med"},{"key":"2026012303275070700_usaf334-B21","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1056\/NEJMoa040603","article-title":"Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care","volume":"351","author":"Hoge","year":"2004","journal-title":"N Engl J Med"},{"key":"2026012303275070700_usaf334-B22","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1097\/PSY.0b013e31822232bb","article-title":"Posttraumatic stress disorder in anorexia nervosa","volume":"73","author":"Reyes-Rodr\u00edguez","year":"2011","journal-title":"Psychosom Med"},{"key":"2026012303275070700_usaf334-B23","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1037\/0022-006X.68.5.748","article-title":"Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults","volume":"68","author":"Brewin","year":"2000","journal-title":"J Consult Clin Psychol"},{"key":"2026012303275070700_usaf334-B24","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.eurpsy.2019.08.007","article-title":"The effect of the Suicide Prevention Program (SPP) on the characteristics of Israeli soldiers who died by suicide after its implementation","volume":"62","author":"Shelef","year":"2019","journal-title":"Eur Psychiatry"},{"key":"2026012303275070700_usaf334-B25","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1177\/1534765613476230","article-title":"Sexual harassment and sexual assault in the military: a review of the literature","volume":"19","author":"Street","year":"2013","journal-title":"Traumatology"},{"key":"2026012303275070700_usaf334-B26","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1080\/08995605.2022.2151815","article-title":"Factors associated with self-harm behaviors during military service in the Israel Defense Forces, rates of such behaviors and their outcomes","volume":"36","author":"Shelef","year":"2024","journal-title":"Mil Psychol"},{"key":"2026012303275070700_usaf334-B27","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1016\/j.janxdis.2019.01.003","article-title":"Combat and operational risk factors for post-traumatic stress disorder symptom criteria among United States Air Force remotely piloted aircraft \u201cdrone\u201d warfighters","volume":"62","author":"Chappelle","year":"2019","journal-title":"J Anxiety Disord"},{"key":"2026012303275070700_usaf334-B28","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1002\/ijop.12917","article-title":"Exposure to combat experiences: PTSD, somatization and aggression amongst combat and non-combat veterans","volume":"58","author":"Harwood-Gross","year":"2023","journal-title":"Int J Psychol"},{"key":"2026012303275070700_usaf334-B29","first-page":"41","article-title":"Mental challenges and mental fitness among observations systems operators in the IDF","volume":"15","author":"Ohayon","year":"2018","journal-title":"Mil Med"},{"key":"2026012303275070700_usaf334-B30","doi-asserted-by":"publisher","first-page":"395","DOI":"10.4172\/1522-4821.1000395","article-title":"The SIX Cs model for immediate cognitive psychological first aid: from helplessness to active efficient coping","volume":"20","author":"Farchi","year":"2018","journal-title":"Int J Emerg Ment Health"},{"key":"2026012303275070700_usaf334-B31","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1037\/tra000048731328939","article-title":"Rapid response to acute stress reaction: Pilot test of iCOVER training for military units","volume":"12","author":"Adler","year":"2020","journal-title":"Psychol Trauma"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/1-2\/e267\/63579912\/usaf334.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/1-2\/e267\/63579912\/usaf334.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T08:28:01Z","timestamp":1769156881000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/191\/1-2\/e267\/8173720"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,20]]},"references-count":31,"journal-issue":{"issue":"1-2","published-online":{"date-parts":[[2025,6,20]]},"published-print":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaf334","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2025,6,20]]}}}