title: Evaluation of a weight management program for veterans.
abstract: BACKGROUND
  To improve the health of overweight and obese veterans, the Department of Veterans Affairs (VA) developed the MOVE! Weight Management Program for Veterans. The aim of this evaluation was to assess its reach and effectiveness.
  
  
  METHODS
  We extracted data on program involvement, demographics, medical conditions, and outcomes from VA administrative databases in 4 Western states. Eligibility criteria for MOVE! were being younger than 70 years and having a body mass index (BMI, in kg/m(2)) of at least 30.0, or 25.0 to 29.9 with an obesity-related condition. To evaluate reach, we estimated the percentage of eligible veterans who participated in the program and their representativeness. To evaluate effectiveness, we estimated changes in weight and BMI using multivariable linear regression.
  
  
  RESULTS
  Less than 5% of eligible veterans participated, of whom half had only a single encounter. Likelihood of participation was greater in women, those with a higher BMI, and those with more primary care visits, sleep apnea, or a mental health condition. Likelihood of participation was lower among those who were younger than 55 (vs 55-64), widowed, current smokers, and residing farther from the medical center (≥30 vs <30 miles). At 6- and 12-month follow-up, participants lost an average of 1.3 lb (95% confidence interval [CI], -2.6 to -0.02 lb) and 0.9 lb (95% CI, -2.0 to 0.1 lb) more than nonparticipants, after covariate adjustment. More intensive treatment (≥6 encounters) was associated with greater weight loss at 12 months (-3.7 lb; 95% CI, -5.1 to -2.3 lb).
  
  
  CONCLUSIONS
  Few eligible patients participated in the program during the study period, and overall estimates of effectiveness were low.
authors.affiliation: Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System (152E), 1100 Olive Way, Ste 1400, Seattle, Washington 98101, USA. alyson@u.washington.edu
authors.forename: Alyson J
authors.initials: AJ
authors.lastname: Littman
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
authors.forename: Mary B
authors.initials: MB
authors.lastname: McDonell
authors.forename: Stephan D
authors.initials: SD
authors.lastname: Fihn
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D015397:Program Evaluation; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D015431:Weight Loss / Q000502:physiology*