Coughlin, Steven S, Kang, Han K, Mahan, Clare M · The open epidemiology journal · 2011 · DOI
This study looked at nearly 10,000 Gulf War veterans and veterans from the same era to see if weight and obesity were connected to health problems like chronic fatigue syndrome (CFS), post-traumatic stress disorder (PTSD), and multi-symptom illness. The researchers found that obese veterans were more likely to have PTSD, but obesity did not explain why Gulf War veterans had more CFS-like illness or multi-symptom illness compared to other veterans.
For ME/CFS patients and researchers, this study is important because it demonstrates that Gulf War-related CFS-like illness and multi-symptom illness cannot be explained by differences in obesity rates between deployed and non-deployed cohorts. This suggests that deployment-related exposures or other factors, not lifestyle-related weight gain, are driving the excess CFS burden in this population.
This study does not prove that obesity causes or prevents CFS-like illness, nor does it establish whether obesity and CFS share common pathophysiological mechanisms in Gulf War veterans. The cross-sectional design means associations are correlational only, and self-reported height and weight data introduce measurement error that could bias results. The study also does not clarify the temporal relationship between weight gain and symptom onset.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Coughlin, Steven S, Kang, Han K, & Mahan, Clare M (2011). Selected Health Conditions Among Overweight, Obese, and Non-Obese Veterans of the 1991 Gulf War: Results from a Survey Conducted in 2003-2005.. The open epidemiology journal. https://doi.org/10.2174/1874297101104010140
BibTeX
@article{mecfsatlas-coughlin-2011-selected-health,
author = {Coughlin, Steven S and Kang, Han K and Mahan, Clare M},
title = {Selected Health Conditions Among Overweight, Obese, and Non-Obese Veterans of the 1991 Gulf War: Results from a Survey Conducted in 2003-2005.},
journal = {The open epidemiology journal},
year = {2011},
doi = {10.2174/1874297101104010140},
note = {PubMed: 21731594},
url = {https://www.mecfsatlas.com/evidence/coughlin-2011-selected-health},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/coughlin-2011-selected-health
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