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Am J Prev Med. 2014 May;46(5):465-72. doi: 10.1016/j.amepre.2013.11.018.

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

Author information

1
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Duke University, Durham, North Carolina; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina. Electronic address: megan.mcvay@va.gov.
2
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Duke University, Durham, North Carolina; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina.
3
Division of General Internal Medicine, University of Michigan, Ann Arbor, Michigan; Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan.
4
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Duke University, Durham, North Carolina.
5
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Duke University, Durham, North Carolina; Department of Biostatistics & Bioinformatics, Duke University, Durham, North Carolina.
6
Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina.

Abstract

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.

PMID:
24745636
DOI:
10.1016/j.amepre.2013.11.018
[Indexed for MEDLINE]

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