scholarly journals Outcome by Gender in the Veterans Health Administration Motivating Overweight/Obese Veterans Everywhere Weight Management Program

2018 ◽  
Vol 27 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Bryan C. Batch ◽  
Karen Goldstein ◽  
William S. Yancy ◽  
Linda L. Sanders ◽  
Susanne Danus ◽  
...  
Keyword(s):  
Weight Management ◽  
Veterans Health Administration ◽  
Management Program ◽  
Weight Management Program ◽  
Veterans Health ◽  
Health Administration

scholarly journals The Effectiveness of Adding Pharmacotherapy to Dietary Counseling for Veterans in a Veterans Health Administration Move! Weight Management Program

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A38-A38
Author(s):  
Diego Alcaraz Alvarez ◽  
Mary F Salter ◽  
Namita Gupta ◽  
Thiyagarajan Thangavelu ◽  
Cyrus V Desouza
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Management Program ◽  
Fat Free Mass ◽  
Weight Management Program ◽  
Veterans Health ◽  
Health Administration ◽  
Weight Changes ◽  
Dietary Counseling ◽  
Weight Loss Medication

Abstract Background: Over 78% of veterans are overweight or obese. MOVE! is the VA’s national evidence-based self-management program. This program focuses on health and wellness through healthy eating, physical activity, and behavior change (1). We evaluated the effects of adding pharmacotherapy to dietitian coaching in a real-world MOVE! Program in the VA Nebraska-Western Iowa Health Care System. Methods: A systematic retrospective and prospective chart review were completed of 66 patients who completed a minimum of 6 months of medication at our Weight Loss Medicine clinic from June 2017 to February 2020. Body composition was measured using SECA Bio Electrical Impedance Analyzer. Descriptive statistics were used to analyze weight changes, fat mass (FM), and fat-free mass (FFM) changes at 6 and 12 months after starting weight loss medications. Results: The percentage of patients with a 5% decrease in weight from baseline after at least 6 months with pharmacotherapy was 47% and a 10% decrease was 36% after 12 months. In 6 months, a decrease of a minimum of 5% was seen with GLP-1 (semaglutide or liraglutide) 55 % (29/53), orlistat 11% (1/9), and bupropion-topiramate 25 % (1/4). An average of 3.4% FM decrease and a 3.47% FFM increase was seen from baseline to 6 months and 4.8% FM decrease and 4.7% FFM increase was seen from baseline to 12 months. Conclusion: A clinically significant decrease in weight was seen at 6 and 12 months after starting weight loss medication in addition to monthly MOVE! Dietitian visits. A significant decrease was seen in FM and an increase in FFM. Veteran’s receiving a GLP-1 had a greater amount of weight loss compared with Orlistat and bupropion-topiramate. Weight loss medication is recommended as an adjunct to dietitian counseling for optimizing weight loss. References 1 Kinsinger LS, Jones KR, Kahwati L et al. Design and dissemination of the MOVE! Weight-Management Program for Veterans. Prev Chronic Dis 2009; 6: A98

Best Practices in the Veterans Health Administration's MOVE! Weight Management Program

2011 ◽  
Vol 41 (5) ◽  
pp. 457-464 ◽  
Author(s):  
Leila C. Kahwati ◽  
Megan A. Lewis ◽  
Heather Kane ◽  
Pamela A. Williams ◽  
Patrick Nerz ◽  
...  
Keyword(s):  
Best Practices ◽  
Weight Management ◽  
Management Program ◽  
Weight Management Program ◽  
Veterans Health

scholarly journals Antidepressant Effect of the VA Weight Management Program (MOVE) Among Veterans With Severe Obesity

2020 ◽  
Vol 185 (5-6) ◽  
pp. e586-e591
Author(s):  
Paulo R Shiroma ◽  
Tina Velasquez ◽  
Timothy J Usset ◽  
John H Wilhelm ◽  
Paul Thuras ◽  
...  
Keyword(s):  
Weight Loss ◽  
Energy Expenditure ◽  
Weight Management ◽  
Severe Obesity ◽  
Management Program ◽  
Antidepressant Effect ◽  
Weight Management Program ◽  
Health Administration ◽  
History Of ◽  
Severity Of Depression

Abstract Introduction Obesity is prevalent among users of Veteran’s Health Administration services, where it is comorbid with depression, post-traumatic stress disorder, type 2 diabetes, cardiovascular disease, colon, and breast cancer. Among obese subjects, severe obesity represents a subpopulation with the highest risk of depression. We investigate the antidepressant effect of a local VA weight management program (Managing Overweight Veterans Everywhere – MOVE) among depressed veterans with severe obesity. Material and Methods In a 10-week prospective pilot study, 14 clinically depressed veterans with severe obesity were recruited from: (1) the 2-week residential based intense MOVE program (IMP) (N = 7) and (2) the 10-week educational module of self-management MOVE program (SMP) (N = 7). Subjects had a Beck Depression Inventory, 2nd edition (BDI-II) score > 12 and BMI > 40 or BMI > 35 with associated to comorbid conditions. Concurrent treatment for depression such as medications or psychotherapy was excluded. The primary efficacy endpoint was the change in BDI-II score form baseline to week 10. Analysis consisted of linear mixed model with baseline BDI-II score as a covariate, and level of MOVE intervention (IMP vs. SMP), time, and time by treatment interaction as fixed effects, and random patient effect. Pearson’s correlation examined the relationships between clinical and demographic variables and change in severity of depression by BDI-II scores. Secondary outcomes include weight loss and energy expenditure. Results The sample was composed by 14 subjects (IMP = 7; SMP = 7) mostly unemployed (N = 9), married (N = 10), mid-aged (mean = 58.2, SD = 8.4), Caucasian (N = 13), male (N = 12), with recurrent depression (N = 11), and a mean overall duration of current depressive episode of 13.5 months (SD = 10.2). Out of 14 participants; seven had a family history of mood disorder, two had previous psychiatric hospitalization, three had a previous suicidal attempt, and eight had a history of substance use disorder. There was a significant decrease in severity of depression among all 14 (F3,36.77 = 5.28; P < 0.01); antidepressant effect favored the IMP compared to SMP at day 12 (F1,15.10 = 9.37, P = 0.01) and week 6 (F2,27.34 = 4.26, P = 0.03), but effect fell short of significance at week 10. The change in severity of depression measured by BDI-II score significantly correlated with total weight loss (r = −0.60; P = 0.04) and daily energy expenditure at 12 days (r = −0.67; P = 0.01), week 6 (r = −0.59; P = 0.03), and week 10 (r = −0.71; P = 0.01). Conclusions Depressed veterans with severe obesity improved their depressive symptoms by participating in the MOVE program. Veterans in the IMP had greater but short-term antidepressant effect as compared to educational intervention for obesity. Future studies with larger sample size may elucidate the underlying mechanisms of weight reduction to improve depression and, more importantly, sustain response among veterans with severe obesity.

scholarly journals Adoption and Appropriateness of mHealth for Weight Management in the Real World: A Qualitative Investigation of Patient Perspectives

10.2196/29916 ◽  
2021 ◽  
Vol 5 (12) ◽  
pp. e29916
Author(s):  
Jessica Y Breland ◽  
Khizran Agha ◽  
Rakshitha Mohankumar
Keyword(s):  
Health Care ◽  
Weight Management ◽  
Real World ◽  
Health Care Policy ◽  
Veterans Health Administration ◽  
The United States ◽  
Free Access ◽  
Veterans Health ◽  
Perceived Fit ◽  
Health Administration

Background Mobile health (mHealth) interventions for weight management can result in weight loss outcomes comparable to in-person treatments. However, there is little information on implementing these treatments in real-world settings. Objective This work aimed to answer two implementation research questions related to mHealth for weight management: (1) what are barriers and facilitators to mHealth adoption (initial use) and engagement (continued use)? and (2) what are patient beliefs about the appropriateness (ie, perceived fit, relevance, or compatibility) of mHealth for weight management? Methods We conducted semistructured interviews with patients with obesity at a single facility in an integrated health care system (the Veterans Health Administration). All participants had been referred to a new mHealth program, which included access to a live coach. We performed a rapid qualitative analysis of interviews to identify themes related to the adoption of, engagement with, and appropriateness of mHealth for weight management. Results We interviewed 24 veterans, seven of whom used the mHealth program. Almost all participants were ≥45 years of age and two-thirds were White. Rapid analysis identified three themes: (1) coaching both facilitates and prevents mHealth adoption and engagement by promoting accountability but leading to guilt among those not meeting goals; (2) preferences regarding the mode of treatment delivery, usability, and treatment content were barriers to mHealth appropriateness and adoption, including preferences for in-person care and a dislike of self-monitoring; and (3) a single invitation was not sufficient to facilitate adoption of a new mHealth program. Themes were unrelated to participants’ age, race, or ethnicity. Conclusions In a study assessing real-world use of mHealth in a group of middle-aged and older adults, we found that—despite free access to mHealth with a live coach—most did not complete the registration process. Our findings suggest that implementing mHealth for weight management requires more than one information session. Findings also suggest that focusing on the coaching relationship and how users’ lives and goals change over time may be an important way to facilitate engagement and improved health. Most participants thought mHealth was appropriate for weight management, with some nevertheless preferring in-person care. Therefore, the best way to guarantee equitable care will be to ensure multiple routes to achieving the same behavioral health goals. Veterans Health Administration patients have the option of using mHealth for weight management, but can also attend group weight management programs or single-session nutrition classes or access fitness facilities. Health care policy does not allow such access for most people in the United States; however, expanded access to behavioral weight management is an important long-term goal to ensure health for all.

scholarly journals Adoption and Appropriateness of mHealth for Weight Management in the Real World: A Qualitative Investigation of Patient Perspectives (Preprint)

2021 ◽  
Author(s):  
Jessica Y Breland ◽  
Khizran Agha ◽  
Rakshitha Mohankumar
Keyword(s):  
Health Care ◽  
Weight Management ◽  
Real World ◽  
Health Care Policy ◽  
Veterans Health Administration ◽  
The United States ◽  
Free Access ◽  
Veterans Health ◽  
Perceived Fit ◽  
Health Administration

BACKGROUND Mobile health (mHealth) interventions for weight management can result in weight loss outcomes comparable to in-person treatments. However, there is little information on implementing these treatments in real-world settings. OBJECTIVE This work aimed to answer two implementation research questions related to mHealth for weight management: (1) what are barriers and facilitators to mHealth adoption (initial use) and engagement (continued use)? and (2) what are patient beliefs about the appropriateness (ie, perceived fit, relevance, or compatibility) of mHealth for weight management? METHODS We conducted semistructured interviews with patients with obesity at a single facility in an integrated health care system (the Veterans Health Administration). All participants had been referred to a new mHealth program, which included access to a live coach. We performed a rapid qualitative analysis of interviews to identify themes related to the adoption of, engagement with, and appropriateness of mHealth for weight management. RESULTS We interviewed 24 veterans, seven of whom used the mHealth program. Almost all participants were ≥45 years of age and two-thirds were White. Rapid analysis identified three themes: (1) coaching both facilitates and prevents mHealth adoption and engagement by promoting accountability but leading to guilt among those not meeting goals; (2) preferences regarding the mode of treatment delivery, usability, and treatment content were barriers to mHealth appropriateness and adoption, including preferences for in-person care and a dislike of self-monitoring; and (3) a single invitation was not sufficient to facilitate adoption of a new mHealth program. Themes were unrelated to participants’ age, race, or ethnicity. CONCLUSIONS In a study assessing real-world use of mHealth in a group of middle-aged and older adults, we found that—despite free access to mHealth with a live coach—most did not complete the registration process. Our findings suggest that implementing mHealth for weight management requires more than one information session. Findings also suggest that focusing on the coaching relationship and how users’ lives and goals change over time may be an important way to facilitate engagement and improved health. Most participants thought mHealth was appropriate for weight management, with some nevertheless preferring in-person care. Therefore, the best way to guarantee equitable care will be to ensure multiple routes to achieving the same behavioral health goals. Veterans Health Administration patients have the option of using mHealth for weight management, but can also attend group weight management programs or single-session nutrition classes or access fitness facilities. Health care policy does not allow such access for most people in the United States; however, expanded access to behavioral weight management is an important long-term goal to ensure health for all.

Sign in / Sign up

Export Citation Format

Share Document