Dr. Finnerty is a psychologist who writes nexus letters for VA disability claims. This includes writing nexus letters for issues secondary to psychological issues with obesity as an intermediary when applicable. For example, sleep apnea secondary to PTSD, depression, anxiety, etc. (including obesity from those psychological conditions) as well as cases related to hypertension, GERD, diabetes, etc.
Here is some sample language and research Dr. Finnerty sometimes uses when obesity may be a factor in the case
Psychiatric difficulties negatively impact motivation (ex: reducing activity) and can lead to overeating. His psychiatric difficulties increase the risk for weight gain, which in turn further increases the risk for obstructive sleep apnea. The Veteran’s weight gain occurred in the context of his mental health. Mental health difficulties are associated with binge eating symptoms in both men and women; [ex: see Braun J, El-Gabalawy R, Sommer JL, Pietrzak RH, Mitchell K, Mota N. Trauma exposure, DSM-5 posttraumatic stress, and binge eating symptoms: results from a nationally representative sample. The Journal of Clinical Psychiatry. 2019;80(6):19m12813]. Hoerster, et. al. (2015) noted “depression symptoms are associated with binge eating among US Iraq and Afghanistan veterans” [see Eating Behaviors; Volume 17, April 2015, Pages 115-118]. Mental health difficulties, by definition, can impact eating behaviors and activity levels. It is notable that major depressive disorder in the DSM-5-TR (pg. 183) lists diagnostic criteria such as “markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day…” and “significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day…” and “psychomotor agitation or retardation,” and “fatigue or loss of energy nearly every day” and others. PTSD (pg. 302) includes criteria like “markedly diminished interest or participation in significant activities). Overeating and inactivity are symptoms of mental health difficulties which lead to weight gain and obesity.
Weight gain/obesity is not simply a comorbidity; weight gain/obesity is a direct, physical, anatomical effect of mental health difficulties.
-Todd Finnerty, Psy.D.
Even more research and sample language related to sleep apnea (follow the link below):
Sleep apnea secondary to PTSD – Nexus Letters from a Psychologist