Abstract and Introduction
Abstract
Introduction The purpose of this study was to evaluate the effectiveness of the MOVE! Weight Management Program for Veterans (MOVE!) in achieving weight loss in veterans who attended the multidisciplinary weight management program in the VA Greater Los Angeles Healthcare System.
Methods From April 1, 2006, to December 31, 2009, 382 veterans enrolled in the MOVE! program; 377 veterans attended at least 3 group sessions and were included in this study. All veterans were encouraged to complete 8 weekly group sessions on nutrition, lifestyle changes, and behavior modification in a group setting led by a multidisciplinary team. After completing the session, veterans had the option of continuing with a support group that meets monthly. The change in weight from 1 year pre-enrollment in MOVE! to 1, 2, and 3 years postenrollment was analyzed.
Results Veterans gained 1.4 kg per year (standard error [SE] = 0.47, P = .003) before enrolling in MOVE!. One year after the enrollment participants lost on average 2.2 kg (SE = 0.42; P < .001). The pre-enrollment slope for weight change was significantly different from the postenrollment slope.
Conclusion Findings from this study support the need for a long-term weight management program such as MOVE! in primary care settings to assist overweight and obese VA patients in achieving and maintaining weight loss to reduce the risk and progression of age-related chronic diseases such as diabetes and heart disease.
Introduction
Obesity is associated with higher rates of hypertension, dyslipidemia, diabetes mellitus, degenerative joint disease, and coronary artery disease. These diseases and their treatment may increase the risk of weight gain and make weight loss more challenging. Obesity and overweight are also associated with poor quality of life, premature death, and increased health care costs. Lifestyle factors including excess intake of calories and low levels of physical activity are central causes of obesity, and the combination of increased physical activity, reduced caloric intake, and other behavior modifications results in weight loss for overweight people.
The prevalence of overweight and obesity in veterans is higher than in the general population but may be similar when the demographics of the veteran population are considered. Programs that can help participants achieve weight losses as small as 5% of their body weight can help them reduce the risk of chronic conditions such as type 2 diabetes. Intensive interventions such as the Diabetes Prevention Program and the Look Ahead trials have been effective in helping participants achieve clinically significant weight loss.
Adapting these research programs into ambulatory programs that can be feasibly delivered through the US Department of Veterans Affairs (VA) is challenging; the Veterans Health Administration (VHA) provides care to almost 6 million veterans through a nationwide network. In response to the challenge of obesity in VHA, the MOVE! Weight Management Program for Veterans (MOVE!) program was piloted between 2002 and 2004 and was nationally implemented in 2006. By 2009, nearly all (98.7%) of the 155 medical centers in VHA reported having MOVE! programs in place. In the Greater Los Angeles VA, a multidisciplinary MOVE! weight management program has been in place since April 2006. However, a recent survey of VA patients in 4 Western states indicated that less than 5% of veterans who were candidates for MOVE! participated. Therefore, optimizing this program and increasing general awareness of its beneficial long-term results could be used to market this no-cost program to more veterans. In that cross-sectional and longitudinal study, women were more likely to participate than men but were less likely to have clinically relevant weight loss. Therefore, improvements to the MOVE! program can be made in different locations, and different features can be emphasized. Evaluation of components that appear to be working among the various sites of this VA program is needed.
The purpose of this study was to determine significant predictors of weight loss at 3 years in veterans who attended the MOVE! multidisciplinary weight management program at the VA Greater Los Angeles Healthcare System (VAGLAHS). Findings from this study can provide evidence to support the need for a lifestyle modification program such as MOVE! in primary care settings to assist overweight and obese veterans in managing their weight.