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Obesity-related health status changes and weight-loss treatment utilization.

McVay MA, Yancy WS, Vijan S, Van Scoyoc L, Neelon B, Voils CI, Maciejewski ML. Obesity-related health status changes and weight-loss treatment utilization. American journal of preventive medicine. 2014 May 1; 46(5):465-72.

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BACKGROUND: Behavioral weight-loss treatment can improve health, yet it is underutilized. Factors leading to initiation of weight-loss treatment are not well characterized. In particular, it is unknown whether changes in obesity-related health status contribute to weight-loss treatment initiation. PURPOSE: To determine if recent weight change or diagnosis of an obesity-related comorbidity was associated with utilization of a behavioral weight-loss program in an integrated healthcare setting. METHODS: In a retrospective cohort study of 45,272 Veterans Affairs (VA) patients with BMI > 30, logistic regression was used to examine whether recent weight change or obesity-related comorbidities newly diagnosed in the past 6 months were associated with initiation of a VA behavioral weight management program (called MOVE!) in 2010 or sustained MOVE! use (eight or more sessions). Weight change in prior year was categorized as > 3% weight loss; weight stable ( < 3% change); or weight gain of 3%-4.9%, 5%-9.9%, or 10%. Data were analyzed in 2013. RESULTS: Patients were 91% male, 68% white, and had a mean age of 58 years. Patients were more likely to initiate treatment if they had 3% weight gain (3%-4.9%: OR = 1.64, 95% CI = 1.52, 1.77; 5%-9.9%: OR = 1.99, 95% CI = 1.84, 2.16; 10%: OR = 2.68, 95% CI = 2.32, 3.10) or were newly diagnosed with any obesity-related comorbidity (ORs: 2.14-3.59). Weight change and new comorbidity diagnoses were not associated, however, with sustained MOVE! use. CONCLUSIONS: Adverse obesity-related health events were associated with initiation of behavioral weight-loss treatment offered in an integrated healthcare setting.

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