Use of obesity-related care by psychiatric patients.
OBJECTIVE
The objective of this study was to assess receipt of obesity care by patients with and without mental illness.


METHODS
The sample consisted of 254,051 obese primary care patients surviving through fiscal year (FY) 2006. Administrative data for Veterans Health Administration (VHA) patients who were obese in FY 2002 (body mass index ≥30) and received primary care in one of six selected VHA regions were included. Outcomes were receipt of obesity care and weight loss during FY 2002-FY 2006. Covariates included baseline mental illness (major depression, posttraumatic stress disorder, and substance use disorders; ICD-9-CM codes 290-311); psychotropic medications associated with weight gain; comorbidity; and demographic characteristics.


RESULTS
Most patients were male (95%), non-Hispanic white (80%), older than 50 (mean±SD=61±12) with comorbid hypertension (65%) and dyslipidemia (50%). One-fifth (20%) had mental illness, primarily depression (8%) or posttraumatic stress disorder (6%). Ten percent of the sample lost weight, and 7% gained ≥10% from baseline weight). Although one-third (34%) received obesity care during the study period, receipt of this care was more common among patients with psychiatric diagnoses (46% versus 31%). In multivariable analysis, psychiatric patients prescribed obesogenic psychotropic medications were more likely than other patients to receive obesity care (interaction effect).


CONCLUSIONS
VHA efforts to help obese patients manage their weight appeared more common for patients prescribed obesogenic psychotropic medication, especially those with psychiatric diagnoses. The results of this study represent an unusual example in which psychiatric patients were relatively more likely to receive care addressing cardiometabolic risk factors.
Center for Applied Health Research, Central Texas Veterans Health Care System, 2102 Birdcreek Dr., Temple, TX 76502, USA. laurelacopeland@gmail.com
Laurel Anne
LA
Copeland
Mary Jo
MJ
Pugh
Paul B
PB
Hicks
Polly Hitchcock
PH
Noel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015897:Comorbidity; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology* / Q000628:therapy*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D058014:Veterans Health; D015430:Weight Gain / Q000187:drug effects; D055815:Young Adult
D011619:Psychotropic Drugs