The Influence of Sleep Disordered Breathing on Weight Loss in a National Weight Management Program.
OBJECTIVE
To investigate the influence of sleep disordered breathing (SDB) on weight loss in overweight/obese veterans enrolled in MOVE!, a nationally implemented behavioral weight management program delivered by the National Veterans Health Administration health system.


METHODS
This observational study evaluated weight loss by SDB status in overweight/obese veterans enrolled in MOVE! from May 2008-February 2012 who had at least two MOVE! visits, baseline weight, and at least one follow-up weight (n = 84,770). SDB was defined by International Classification of Diseases, Ninth Revision, Clinical Modification codes. Primary outcome was weight change (lb) from MOVE! enrollment to 6- and 12-mo assessments. Weight change over time was modeled with repeated-measures analyses.


RESULTS
SDB was diagnosed in one-third of the cohort (n = 28,269). At baseline, veterans with SDB weighed 29 [48] lb more than those without SDB (P < 0.001). On average, veterans attended eight MOVE! visits. Weight loss patterns over time were statistically different between veterans with and without SDB (P < 0.001); veterans with SDB lost less weight (-2.5 [0.1] lb) compared to those without SDB (-3.3 [0.1] lb; P = 0.001) at 6 months. At 12 mo, veterans with SDB continued to lose weight whereas veterans without SDB started to re-gain weight.


CONCLUSIONS
Veterans with sleep disordered breathing (SDB) had significantly less weight loss over time than veterans without SDB. SDB should be considered in the development and implementation of weight loss programs due to its high prevalence and negative effect on health.
Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI.
Carol A
CA
Janney
Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI.|VA Quality Enhancement Research Initiative (QUERI), Health Services Research and Development, Washington DC.|Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI.
Amy M
AM
Kilbourne
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Anne
A
Germain
Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI.
Zongshan
Z
Lai
Seattle Division Mental Health Service, VA Puget Sound Healthcare System, Seattle, WA.|Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA.
Katherine D
KD
Hoerster
Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI.
David E
DE
Goodrich
VA Maryland Healthcare System and University of Maryland School of Medicine, Baltimore, MD.
Elizabeth A
EA
Klingaman
Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI.
Lilia
L
Verchinina
Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI.|Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, MI.
Caroline R
CR
Richardson
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D050177:Overweight / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D015995:Prevalence; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data; D015431:Weight Loss; D055815:Young Adult
MOVE!; obesity; population health; sleep apnea; veterans; weight loss