Orthopedic Problems and Amputations
The VA routinely denies veterans who have severe orthopedic problems, partial paralysis, and/or amputations for disabilities related to their obesity. While there are many exercises that can be performed by amputees and those with severe orthopedic problems, it is certainly much more difficult to exercise with these problems than without. However, this is not the only link between these problems and obesity.
Science shows us that amputees are at a greater risk of obesity, and this risk rises with the degree of amputation. Studies like this show us that obesity is not only a problem because of the relative difficulty of exercise, but that there are also measurable biochemical changes in the body of amputees, notably with regards to the way that we metabolize lipids. The study also notes that exercise does NOT reduce body mass as quickly in amputees as in the general population.
In addition, amputees often deal with mental health changes, including depression, which I will expand on later in this article.
Mental illness often correlates with large fluctuations in weight. Some with depression or anxiety disorders may lose weight, some may gain weight. In the past, most doctors have believed the correlation between depression obesity meant that obesity and lack of exercise were causing depression. However, new research is beginning to show us that those with depressive symptoms experience a greater rate of weight gain than those without depression. This makes sense for several reasons, as some of the most common symptoms of depression can contribute to weight gain. Those with depression often experience a loss of energy, diminished pleasure in activities such as sports and exercise, “comfort eating,” and depression can cause real, actual pain in the body and joints. These symptoms can make it extremely difficult to keep one’s body in tip-top shape.
With PTSD, we can see similar studies with similar results. Those with PTSD have been shown to experience a steep increase in BMI after developing PTSD symptoms. PTSD can have massive repercussions in the body, and the very same stress hormones and areas of the brain that are affected by PTSD are also involved in hunger and metabolism. Alongside these physiological changes, we also have decreased interest in physical activity, as well as “stress eating.”
To complicate it even further, often the drugs used to treat PTSD and depression cause chemical changes in the brain and body that also contribute to obesity (see part two of this series.)
We can see that obesity is not as simple as “eat less cheeseburgers and exercise more.” The VA seems to categorize obesity as a sort of “willful misconduct.” However, as we’ve seen in this series, obesity has many causes and many of them may be directly related to your military service.