Possible Contribution of PTSD to Altered Cortisol Activity in Young Adult Obese African-American Women.

OBJECTIVE: African-Americans have been found to experience increased rates of post-traumatic stress disorder (PTSD), obesity, and flatter diurnal cortisol slopes compared to other demographic groups. Further exploration, however, is needed to understand how PTSD impacts diurnal cortisol activity in obese African-American women. The purpose of the current study is to examine the relationship between salivary cortisol levels and PTSD in a sample of obese young adult African-American women and to examine how depression and insomnia influence the relationship. METHODS: Thirty-four young adult African-American women (mean age = 24.0 years; mean BMI = 37.4 kg/m(2), 6/34 of the sample had a score of 40 or above on the PTSD Checklist (PCL) representing clinically significant PTSD) filled out questionnaires assessing PTSD, lifetime exposure to traumatic events, insomnia severity, and depression. A home-based assessment of salivary cortisol was provided upon awakening at 30 min and 1, 3, 6, and 12 h. RESULTS: There was a significant interaction between PTSD status and diurnal cortisol activity (p < 0.04). There were trends for higher cortisol levels at awakening (p < 0.051) and 30 min post-awakening (p < 0.059) with PTSD. The significance of the interaction between PTSD and cortisol was attenuated by co-varying for depression and insomnia (p > 0.05). CONCLUSION: PTSD, influenced by depression and insomnia symptoms, has an impact on diurnal cortisol activity in obese young adult African-American women.

Uncomplicated obesity in an African American population seeking medical weight loss.

OBJECTIVE: Obesity is highly prevalent and adds greatly to the risk of cardiovascular and metabolic diseases. However, a subset of the obese has been identified who do not appear to carry this risk. Some studies suggest that anthropomorphic correlates of risk, such as waist circumference, differ between African Americans and Whites and features of uncomplicated obesity have not been well characterized in this population. The goal of our study was to determine the prevalence and associated features of uncomplicated obesity, including relationships to waist circumference and the achievement of weight loss in primarily African American patients. DESIGN: A retrospective chart review. SETTING: Outpatient medically supervised weight loss program located at a teaching hospital in Washington, DC. PARTICIPANTS: Predominately adult African American females. RESULTS: Thirty-one percent of our population had no documented metabolic or cardiovascular disease. This group was on average younger, but had similar waist circumference (44 +/- 13.8 vs 44 +/- 6.6 inches) and achieved similar mean weight loss at 3 months (9.9 +/- 10.4 vs 10.3 +/- 12.4 lbs.) as the group with comorbid conditions. CONCLUSIONS: Waist circumference was not an indicator of risk among African American women and achieved weight loss did not depend on pre-existing comorbidities.