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Brief Reports   |    
Weight Loss After Participation in a National VA Weight Management Program Among Veterans With or Without PTSD
Katherine D. Hoerster, Ph.D., M.P.H.; Zongshan Lai, M.P.H.; David E. Goodrich, Ed.D.; Laura J. Damschroder, M.S., M.P.H.; Alyson J. Littman, Ph.D., M.P.H.; Elizabeth A. Klingaman, Ph.D.; Karin M. Nelson, M.D., M.S.H.S.; Amy M. Kilbourne, Ph.D., M.P.H.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300404
View Author and Article Information

Dr. Hoerster, Dr. Littman, and Dr. Nelson are with the Seattle Division, U.S. Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington, where Dr. Hoerster is with the Mental Health Service, Dr. Littman is with the Epidemiologic Research and Information Center, and Dr. Nelson is with the Health Services Research & Development program (e-mail: katherine.hoerster@va.gov). They are also with the University of Washington, in Seattle, where Dr. Hoerster is with the Department of Psychiatry and Behavioral Sciences, Dr. Littman is with the Department of Epidemiology, and Dr. Nelson is with the Department of Medicine, Division of General Internal Medicine. Mr. Lai, Dr. Goodrich, Ms. Damschroder, and Dr. Kilbourne are with the VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, and Mr. Lai, Dr. Goodrich, and Dr. Kilbourne are also with the Department of Psychiatry, University of Michigan Medical School, also in Ann Arbor. Dr. Klingaman is with the VA Capitol Health Care Network Mental Illness Research, Education and Clinical Center, VA Maryland Health Care System, Baltimore, and with the Department of Psychiatry, University of Maryland School of Medicine, also in Baltimore. A poster containing preliminary findings from this study was presented at the Society of Behavioral Medicine annual meeting, San Francisco, March 20–23, 2013.

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  This evaluation compared the effectiveness of MOVE!, a U.S. Veterans Health Administration (VHA) weight management program, among veterans with posttraumatic stress disorder (PTSD), other mental conditions, or no mental health diagnoses.

Methods  VHA administrative data from 2008 to 2012 were used to estimate adjusted six- and 12-month weight change and ≥5% weight loss among 20,819 veterans with “intense and sustained” MOVE! participation (14% of 148,963 MOVE! participants, regardless of mental health status).

Results  Compared with veterans with no mental health diagnoses, veterans with PTSD lost significantly less weight at six and 12 months (p<.05) and were less likely to lose ≥5% body weight at six months (OR=.89, p<.05). At six months, those with other mental conditions lost significantly less weight than those with no mental health diagnoses (p<.05).

Conclusions  MOVE! may need adaptation to increase overall engagement and enhance weight loss for veterans with mental conditions, especially PTSD.

Abstract Teaser
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Table 1Characteristics of 20,819 veterans with intense and sustained participation in MOVE! in fiscal years 2008–2012, by mental health statusa
Table Footer Note

a All bivariate associations between veterans’ characteristics and mental health status were significant (p<.001), except ≥5% weight loss at 12 months.

Table Footer Note

b Scores reflect the total number of diagnoses for general medical conditions associated with at least one VHA visit in the current or prior fiscal year.

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