title: Weight loss intention, dietary behaviors, and barriers to dietary change in veterans with lower extremity amputations.
abstract: BACKGROUND
  Obesity is thought to be highly prevalent in persons with lower extremity amputations (LEAs) and can impair physical and social functioning.
  
  
  OBJECTIVE
  The aim of this study was to determine the prevalence of weight loss intention, weight loss strategies, dietary patterns, and barriers to making dietary changes, and their associations with body mass index (BMI, kg/m(2)), amputation characteristics, health status, and socioeconomic factors.
  
  
  METHODS
  We conducted a cross-sectional study (n = 150) using data from a self-administered questionnaire.
  
  
  RESULTS
  43% of participants were obese and 48% were trying to lose weight; 83% of those trying to lose weight reported trying to "eat differently", but only 7% were following a comprehensive weight loss program involving dietary changes, physical activity, and behavioral counseling. 21% of participants reported ≥ 6 barriers to changing their eating habits (e.g., habit, too little money, stress/depression). Obesity was associated with younger age, lower physical health scores, hypertension, arthritis, and diabetes. Compared to those not trying to lose weight, a greater proportion of those trying to lose weight had a BMI ≥ 35 kg/m(2), age <55 years, higher physical and mental health scores, and more frequent consumption of vegetables, beans, chicken, and fish.
  
  
  CONCLUSIONS
  Though over half of overweight and obese individuals with LEA were trying to lose weight, few reported following a comprehensive program to lose weight, which may indicate an unmet need for services for this group. To be effective, these programs will need to address the complex physical and mental health challenges that many of these individuals face.
authors.affiliation: Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Healthcare System, 1660 South Columbian Way, Seattle, WA 98108, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA. Electronic address: alyson.littman@va.gov.
authors.forename: A J
authors.initials: AJ
authors.lastname: Littman
authors.affiliation: Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Healthcare System, 1660 South Columbian Way, Seattle, WA 98108, USA; Department of Medicinal Chemistry, University of Washington, Seattle, WA, USA.
authors.forename: L V
authors.initials: LV
authors.lastname: McFarland
authors.affiliation: Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Healthcare System, 1660 South Columbian Way, Seattle, WA 98108, USA; Department of Biostatistics, University of Washington, Seattle, WA, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Thompson
authors.affiliation: Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Healthcare System, 1660 South Columbian Way, Seattle, WA 98108, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Denver-Seattle Center of Innovation for Veteran-Centered & Value Driven Care, Department of Veterans Affairs Puget Sound Healthcare System, 1660 South Columbian Way, Seattle, WA 98108, USA.
authors.forename: E D
authors.initials: ED
authors.lastname: Bouldin
authors.affiliation: Group Health Research Institute, Seattle, WA, USA.
authors.forename: D E
authors.initials: DE
authors.lastname: Arterburn
authors.affiliation: Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Healthcare System, 1660 South Columbian Way, Seattle, WA 98108, USA.
authors.forename: B R
authors.initials: BR
authors.lastname: Majerczyk
authors.affiliation: Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Healthcare System, 1660 South Columbian Way, Seattle, WA 98108, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Boyko
mesh_terms: D000367:Age Factors; D000368:Aged; D000671:Amputation, Surgical; D015992:Body Mass Index; D004032:Diet; D006233:Persons with Disabilities; D005247:Feeding Behavior; D005260:Female; D006262:Health; D006801:Humans; D033182:Intention; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy* / Q000453:epidemiology; D014728:Veterans; D015431:Weight Loss; D061217:Weight Reduction Programs
keywords: Diet; Lower extremity amputation; Obesity; Veterans; Weight loss