title: National evaluation of obesity screening and treatment among veterans with and without mental health disorders.
abstract: OBJECTIVE
  The objective was to determine whether obesity screening and weight management program participation and outcomes are equitable for individuals with serious mental illness (SMI) and depressive disorder (DD) compared to those without SMI/DD in Veterans Health Administration (VHA), the largest integrated US health system, which requires obesity screening and offers weight management to all in need.
  
  
  METHODS
  We used chart-reviewed, clinical and administrative VHA data from fiscal years 2010-2012 to estimate obesity screening and participation in the VHA's weight management program (MOVE!) across groups. Six- and 12-month weight changes in MOVE! participants were estimated using linear mixed models adjusted for confounders.
  
  
  RESULTS
  Compared to individuals without SMI/DD, individuals with SMI or DD were less frequently screened for obesity (94%-94.7% vs. 95.7%) but had greater participation in MOVE! (10.1%-10.4% vs. 7.4%). MOVE! participants with SMI or DD lost approximately 1 lb less at 6 months. At 12 months, average weight loss for individuals with SMI or neither SMI/DD was comparable (-3.5 and -3.3 lb, respectively), but individuals with DD lost less weight (mean=-2.7 lb).
  
  
  CONCLUSIONS
  Disparities in obesity screening and treatment outcomes across mental health diagnosis groups were modest. However, participation in MOVE! was low for every group, which limits population impact.
authors.affiliation: VA Puget Sound Healthcare System, Seattle Division Epidemiologic Research and Information Center (ERIC), Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA. Electronic address: Alyson.littman@va.gov.
authors.forename: Alyson J
authors.initials: AJ
authors.lastname: Littman
authors.affiliation: Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2215 Fuller Road, Mail Stop 152, Ann Arbor, MI, 48105, USA. Electronic address: Laura.damschroder@va.gov.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Damschroder
authors.affiliation: Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2215 Fuller Road, Mail Stop 152, Ann Arbor, MI, 48105, USA. Electronic address: Lilia.verchinina@va.gov.
authors.forename: Lilia
authors.initials: L
authors.lastname: Verchinina
authors.affiliation: Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2215 Fuller Road, Mail Stop 152, Ann Arbor, MI, 48105, USA; Department of Psychiatry, University of Michigan Medical School, North Campus Research Complex, 2800 Plymouth Road, Building 16, Ann Arbor, MI, 48109-2800, USA. Electronic address: Zongshan.Lai@va.gov.
authors.forename: Zongshan
authors.initials: Z
authors.lastname: Lai
authors.affiliation: Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2215 Fuller Road, Mail Stop 152, Ann Arbor, MI, 48105, USA; Center for Statistical Consultation & Research, University of Michigan, Ann Arbor, MI. Electronic address: Myrakim@umich.edu.
authors.forename: Hyungjin Myra
authors.initials: HM
authors.lastname: Kim
authors.affiliation: VA Puget Sound Healthcare System, Seattle Division Mental Health Service; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA. Electronic address: Katherine.hoerster@va.gov.
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Hoerster
authors.affiliation: VA Capitol Health Care Network Mental Illness Research, Education, and Clinical Center, Baltimore, MD; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD. Electronic address: Elizabeth.klingaman@va.gov.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Klingaman
authors.affiliation: VA Capitol Health Care Network Mental Illness Research, Education, and Clinical Center, Baltimore, MD. Electronic address: Richard.goldberg@va.gov.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Goldberg
authors.affiliation: Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, AR; Department of Psychiatry, University of Arkansas for Medical Sciences College of Medicine, Little Rock, AR. Electronic address: Richard.Owen2@va.gov.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Owen
authors.affiliation: Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2215 Fuller Road, Mail Stop 152, Ann Arbor, MI, 48105, USA; Department of Psychiatry, University of Michigan Medical School, North Campus Research Complex, 2800 Plymouth Road, Building 16, Ann Arbor, MI, 48109-2800, USA. Electronic address: David.goodrich2@va.gov.
authors.forename: David E
authors.initials: DE
authors.lastname: Goodrich
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000453:epidemiology; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D058014:Veterans Health / Q000706:statistics & numerical data*; D061217:Weight Reduction Programs / Q000706:statistics & numerical data*
keywords: Depressive disorder; Obesity; Serious mental illness; Veterans; Weight management