Military personnel are at greater risk of psychological disorders and related symptoms than civilians. Limited engagement in health-promoting behaviors may increase symptoms of these disorders. Concurrently, these disorders may impact engagement in health-promoting behaviors.


Self-report data from the 2015 DoD Health Related Behaviors Survey of military personnel were used to estimate bi-directional associations between health-related behaviors (e.g., BMI, physical activity [PA], alcohol use, smoking, sleep) and symptoms of mental health conditions (probable generalized anxiety disorder [GAD], depression, PTSD). Adjustments were made for age, sex, service, race, education, pay grade, marital status, medical diagnoses, addictive behaviors [drinking, illicit and prescription drug misuse]), and complex survey design.


Of 12,708 respondents (37% female; 13% obese), probable depression was reported by 6%, GAD by 10%, and PTSD by 6%. In the fully adjusted model, obesity, low vigorous PA (<75 min/wk), current smoking, less sleep, and more weekly alcoholic drinks were associated with higher odds of probable depression, GAD, and PTSD. Compared to those with normal weight, obesity was associated with 86% higher odds of depression (OR [95%CI]: 1.86 [1.71-2.03]), 50% higher odds of GAD (1.50 [1.23-1.84]), and 23% higher odds of PTSD (1.23 [1.04-1.46]). Concurrently, probable depression, GAD, and PTSD were associated with higher odds of low moderate and vigorous PA, low strength training (<1 d/wk), and fewer hours of sleep. Probable depression and GAD were also associated with higher odds of obesity and smoking.


Obesity and limited engagement in health-promoting behaviors is associated with higher likelihood of probable psychological disorders, and vice-versa. Encouraging and improving health-promoting behaviors may contribute to positive mental health in military personnel. Views expressed do not reflect official policy of the Army, DoD, or U.S. Government.