Military experience strongly influences post-service eating behavior and BMI status in American veterans
Abstract: In-depth interviews were conducted with veterans (n = 64) with an average age of 57 years to investigate eating behavior and food insecurity during military service and examine if it affects post-war eating behavior, and if this contributes to the high incidence of obesity found in veterans. About half of the subjects served during the Vietnam War, while smaller numbers served in WWII, the Korean War, Desert Storm, or other conflicts. The mean BMI was 30.5 ± 6.7 kg/m2. Only 12.5% of participants were classified as normal weight, while 37.5% were overweight, 46.9% were obese, and 3.1% were classified as excessively obese. Five major themes were identified including, (a) military service impacts soldier’s food environment, (b) food insecurity influences eating behavior and food choices, (c) military impacts weight status during and post-service, (d) military service has health consequences, and (e) post-service re-adjustment solutions are needed to ease re-entry into civilian life.
Abstract: Background: Exposure to potentially morally injurious events (PMIEs) during military service can lead to moral injury (MI) outcomes and posttraumatic stress symptoms (PTSS). This longitudinal study examined the relationships between PMIE exposure, MI outcomes, and PTSS among Israeli combat veterans, and the potential protective role of dispositional forgiveness in these associations. Method: Participants were 169 Israeli combat veterans who participated in a six-year longitudinal study with four measurement points (T1: 12 months before enlistment, T2: Six months following enlistment- pre-deployment, T3: 18 months following enlistment- post-deployment, and T4: 28 months following discharge). Participants’ characteristics were assessed via semi-structured interviews (T1) and validated self-report measures (T2-T4) between 2019-2024. Results: Approximately 36% of participants reported exposure to PMIEs during service, with 13% exceeding the clinical threshold for probable PTSD at T4. PMIE-Betrayal at T3 was positively associated with MI outcomes of shame and trust violation at T4. The indirect effect of PMIEs on PTSS through MI outcome-Shame depended on forgiveness levels. Among veterans with low forgiveness, higher exposure to PMIE-Betrayal was associated with increased MI shame, which was linked to more severe PTSS. Conversely, for those with high forgiveness, exposure to PMIE-Self and Other was associated with decreased MI shame and subsequently reduced PTSS. Conclusion: Dispositional forgiveness moderates the relationship between PMIE exposure and MI outcomes, particularly shame, which mediates the development of PTSS. These findings highlight forgiveness as a potential target for intervention in treating moral injury and preventing PTSS among combat veterans.