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Weight loss for women with serious mental illness after participation in a national VA weight management program

Klingaman E, Goldberg R, Verchinina L, Kreyenbuhl J, Littman A, Damschroder LJ, Kim M, Hoerster K, Janney C, Owen R, Goodrich DE, Lai Z. Weight loss for women with serious mental illness after participation in a national VA weight management program. Poster session presented at: VA HSR&D Enhancing Partnerships for Research and Care of Women Veterans Conference; 2014 Jul 31; Washington, DC.




Abstract:

Objectives: Obesity is a critical health issue relevant to women Veterans with serious mental illness (SMI); they are disproportionately affected by obesity and obesity-related conditions than men with SMI or the general population. The Veterans Health Administration serves a large population of female Veterans who have access to MOVE! , a national weight loss program available throughout the VHA healthcare system. This study compared whether weight loss differed between women and men with SMI enrolled in MOVE!. Methods: We used a national database from 143 VA healthcare facilities, comprising N = 148,963 patients who had at least two MOVE! sessions in Fiscal Years 2008-2012. Analyses were restricted to participants with SMI (schizophrenia, bipolar disorder, and/or psychotic disorders), a body mass index (BMI) > 25 kg/m2, 18-70 years of age, and weights at baseline plus at least one follow-up timepoint (n = 7,002). Outcome was weight change at six and twelve months after baseline. Linear regression analysis were employed to identify associations of gender with weight change, adjusting for demographics, BMI, number of MOVE! sessions, %service-connected disability, facility type, alcohol or drug use disorder, smoking, obesity-related comorbidities, and metabolic risk of psychotropic medications. Results: From baseline to six months, weight loss did not differ significantly between women (2.2+0.4lbs.) and men (2.2+0.2lbs.; p = .28). However, from six to twelve months, women with SMI lost significantly more weight (1.5+0.5lbs.) than men with SMI (0.4+0.2lbs.; p < .05). Conclusions: Among Veterans with SMI, not only do women lose a comparable amount of weight to men in the first six months after their MOVE! baseline visit, they lost more weight than men during the next six months. Impacts: Veterans with SMI participating in MOVE! over a twelve-month period lost a small, but notable amount of weight, given that many are on a weight gain trajectory. Women lost more weight than men at twelve months, which is important because they are burdened by higher rates of obesity and related chronic conditions. MOVE! is a relatively new national weight management program and the modest weight loss found in this large-scale evaluation indicates a need to tailor it to the unique needs of this population, to address their disproportionate obesity-related mortality.





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