This Veterans Day, as we honor the service and sacrifice of military veterans, we must also confront the unique and complex health challenges they face after returning to civilian life. Veterans often begin their service with strong physical and mental resilience, but years of service—especially in combat—can leave lasting impacts on both body and mind. Many veterans return home only to develop serious health conditions, including post-traumatic stress disorder (PTSD), substance use disorders, diabetes, and metabolic syndrome. These conditions not only reduce their quality of life but also increase their risk for premature death. This reality underscores an urgent need for a holistic approach to veterans’ healthcare—one that integrates mental and metabolic health.
Metabolic disorders are disproportionately high among veterans. Dr. Mark Cucuzzella, a physician at the Martinsburg VA and a professor at West Virginia University, has seen the prevalence of these conditions firsthand. According to Dr. Cucuzzella, 31% of veterans in his region have type 2 diabetes, and over half meet the criteria for metabolic syndrome. These metabolic issues often co-occur with PTSD, traumatic brain injury (TBI), and hypervigilance—each adding to the stress on the body and exacerbating health risks.
A study of the National Health and Nutrition Examination Survey (NHANES) data confirms these trends. Diabetes rates among veterans rose from 15.5% to 20.5% between 2005 and 2014, far surpassing rates in the civilian population. Rates are even higher now. Veterans who live below the poverty line or lack educational attainment are especially vulnerable, with those in lower socioeconomic brackets experiencing even higher rates of diabetes and obesity.
The link between mental and physical health in veterans is evident. PTSD and combat-related injuries, such as TBI, are known to disrupt hormonal regulation, increase inflammation, and create metabolic imbalances, making veterans more susceptible to diabetes and cardiovascular diseases. This interconnection of health issues creates a vicious cycle: mental health challenges contribute to metabolic dysregulation, while metabolic issues can intensify symptoms of mental illness. Veterans struggling with both face compounded risks, leading to worse overall health outcomes and shorter life expectancies compared to the general population.
Recent data highlights accelerated aging among veterans with PTSD and metabolic conditions. A study published in JAMA Psychiatry used GrimAge, an advanced biomarker of biological age, to measure the effects of PTSD and obesity on biological aging in veterans. The findings revealed that veterans with PTSD were already twice as likely to experience accelerated aging. However, the combination of PTSD and obesity dramatically increased this risk, likely due to combined stress, inflammatory, and metabolic effects. Veterans with both conditions face amplified health risks, indicating a need for integrated care that addresses both PTSD and obesity.
Dr. Cucuzzella’s work emphasizes a practical solution grounded in a “Brain Energy” approach. Using a one-page self-assessment checklist, he empowers veterans to take ownership of their health by setting small, achievable goals. Each marker on the checklist is color-coded, from “red” to “green,” to help veterans assess their current status and focus on improvement. “When I see them,” Dr. Cucuzzella says, “we focus on one thing at a time, but try to move them from ‘red’ to ‘yellow’ to ‘green’ in whichever one they feel is a priority.” This individualized, step-by-step approach helps foster a sense of purpose and agency in the recovery journey—a vital factor in sustaining motivation for long-term health improvement.
Click Here to Download the One-Page Brain Energy Handout
This approach aligns with evidence-based practices that show the benefits of integrated care. Research indicates that mental health challenges like PTSD and depression often go hand-in-hand with substance use disorders and that both benefit from treatment that addresses the root causes, not just the symptoms. For example, nearly one in five veterans with PTSD also has a substance use disorder, and one-third of veterans seeking treatment for substance use also struggle with PTSD. These intertwined conditions need comprehensive, combined treatment, not piecemeal care.
In addition to systemic solutions, veterans also need accessible and culturally competent mental health care. Many veterans face barriers like stigma, financial constraints, and limited VA healthcare resources, making it difficult to access the help they need. Alarmingly, around 17 veterans die by suicide every day, with suicide now accounting for four times as many deaths as combat since 9/11. As Dr. Cucuzzella notes, fostering a sense of purpose in veterans’ lives is essential for successful treatment; without it, recovery efforts risk falling short. This approach goes beyond traditional treatment, recognizing that healing requires both psychological and social support.
For veterans who have trouble accessing mental health care, organizations like The Headstrong Project are making a significant impact by offering confidential, stigma-free PTSD treatment to veterans, service members, and their families. This non-profit is dedicated to breaking down barriers to care and ensuring that those who served our country can heal and thrive.
The health struggles veterans face are multifaceted, and so too must be the solutions. Holistic care that integrates mental and metabolic health, addresses socioeconomic disparities, and prioritizes preventive care can help veterans reclaim their health and find resilience. This Veterans Day, let us commit to honoring veterans not only with words but with action—by pushing for a healthcare model that meets their complex needs and truly supports them in their journey toward recovery.
Dr. Christopher Palmer is a Harvard psychiatrist and researcher working at the interface of metabolism and mental health. He is the Founder and Director of the Metabolic and Mental Health Program and the Director of the Department of Postgraduate and Continuing Education at McLean Hospital and an Assistant Professor of Psychiatry at Harvard Medical School. For almost 30 years, he has held administrative, educational, research, and clinical roles in psychiatry at McLean and Harvard. He has been pioneering the use of the medical ketogenic diet in the treatment of psychiatric disorders—conducting research in this area, treating patients, writing, and speaking around the world on this topic. Most recently, he has proposed that mental disorders can be understood as metabolic disorders affecting the brain, which has received widespread recognition in both national and international media outlets.
