Koepsell TD (Seattle ERIC, University of Washington), Forsberg CW
(Seattle ERIC), Littman AJ
(Seattle ERIC, University of Washington)
Obesity and overweight are major public health problems that may pose special burdens on the Department of Veterans Affairs (VA). We assessed the burden of obesity and overweight, and the frequency of weight control practices and provider advice, among U.S. veterans and users of VA health care in a large national survey.
Data were combined from the 2003 and 2004 Behavioral Risk Factor Surveillance System telephone surveys of U.S. adults (n = 558,426). Sociodemographic characteristics, veteran status, VA healthcare use, body mass index (BMI), weight control practices, and advice from a health provider to lose weight were assessed by interview.
Some 24% of veterans were obese (BMI > = 30 kg/m-squared), and 48% were overweight (BMI 25-29.9 kg/m-squared). After adjustment for age and gender, obesity prevalence was similar between veterans and non-veterans, but overweight was about 3.8 percentage points more frequent in veterans. Among veterans, obesity was more common among VA users (28.6% vs. 23.9%, p < .001), especially those who received all health care through the VA (30.3%). Obese and overweight VA users were more likely than non-users to report advice from a healthcare provider to lose weight (44% vs. 37%, p = .027), but no more likely to report that they were actually trying to lose weight.
Obese or overweight VA users were more likely than obese/overweight VA non-users to report having been advised by a provider to lose weight. Still, only a minority of these VA patients who may benefit from weight loss advice said they had received such advice. Moreover, obese or overweight VA users were no more likely than VA non-users to report actually trying to lose weight.
The high prevalence of obesity and overweight among veterans served by the VA strengthens the case for system-wide interventions aimed at weight control, such as the VA's Managing Overweight and/or Obesity for Veterans Everywhere (MOVE!), initiated in 2004. If future BRFSS surveys include questions on veteran status and VA care use, these data could be valuable in evaluating such programs.