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JGIM Supplement Features VA Research on Weight Management in the VA Healthcare System

March 21, 2017

This special Supplement of the Journal of General Internal Medicine is the product of an HSR&D sponsored state-of-the-art (SOTA) conference titled "Weight Management in the Veterans Health Administration," which was held in 2016. The supplement includes several original papers that discuss findings from the conference, which began by examining behavioral interventions, pharmacotherapy, and bariatric surgery. Unique to this SOTA conference (as reported in the paper by Raffa, et al.) there also was a discussion among the combined workgroups about how to integrate all three approaches in a weight management intervention. Specific findings are discussed in 13 articles on a range of topics related to weight management, including but not limited to:

  • Masheb and colleagues summarize discussion, policy, and research recommendations of the SOTA's Behavioral Interventions Workgroup. Their top policy recommendations were to establish a system-wide culture for weight management - and to identify a population-level health metric to measure the impact of weight management interventions.
  • Semla and colleagues review recommendations from the Pharmacotherapy Workgroup. Faced with the low rate of pharmacotherapy prescribing in VA (< 2% of all patients in VA's MOVE! Weight Management Program), they examined medication effectiveness, which patients benefit, and what barriers to appropriate prescribing exist in VA. Barriers included patient and provider concerns about medication safety and efficacy, and limited involvement of primary care in pharmacotherapy.
  • Peterson and colleagues conducted a rapid evidence review to help better understand bariatric surgery outcomes in adults with a BMI > 50 kg/m2. Their findings showed limited evidence that bariatric surgery is associated with increased mortality in the first year for adults with super obesity compared to usual care, but decreased longer-term mortality. Despite the increased surgical risk, existing evidence suggests that people with a BMI > 50 may benefit from bariatric surgery.

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