title: Pharmacotherapy for Weight Management in the VHA.
abstract: Weight management medications (WMM) are underutilized as an adjunct to behavioral and lifestyle interventions. In fiscal years 2014-2015, a total of approximately 2500 veterans-a mere 2% of veterans receiving care from the Veterans Health Administration (VHA)-eligible for a WMM received a prescription for one. A State of the Art Conference on Weight Management workgroup, focused on pharmacotherapy, developed evidence-based recommendations and strategies to foster the appropriate use of WMM in the VHA. The workgroup identified patient, prescriber, and health system barriers to and facilitators for prescribing WMM. Barriers included patient and provider concerns about medication safety and efficacy, limited involvement of primary care, restrictive medication criteria for use (CFU), and skepticism among providers regarding the safety and efficacy of WMM and the perception of obesity as a disease. Potential facilitators for removing barriers included patient and provider education about WMM and the health benefits of weight loss, increased engagement of primary care providers in weight management, relaxation of the CFU, and creation of a system to help patients navigate through weight management treatment options. Several research questions were framed with regard to WMM in general, and specifically to the care of obese veterans. While some of the workgroup's conclusions reflect issues specific to the VHA, many are likely to be applicable to other health organizations.
authors.affiliation: Pharmacy Benefits Management Services, Department of Veterans Affairs, 1st Ave. - 1 Block N. of Cermak Rd, Building 37 (10P4P), Hines, IL, 60141, USA. Todd.semla@va.gov.|Department of Medicine, and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Todd.semla@va.gov.
authors.forename: Todd P
authors.initials: TP
authors.lastname: Semla
authors.affiliation: VA Connecticut Healthcare System, New Haven, CT, USA.|Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Ruser
authors.affiliation: Pharmacy Benefits Management Services, Department of Veterans Affairs, 1st Ave. - 1 Block N. of Cermak Rd, Building 37 (10P4P), Hines, IL, 60141, USA.|Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.|Division of General Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Chester B
authors.initials: CB
authors.lastname: Good
authors.affiliation: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Susan Z
authors.initials: SZ
authors.lastname: Yanovski
authors.affiliation: David Geffen School of Medicine, University of California, Los Angeles, CA, USA.|West Los Angeles VA Medical Center, Los Angeles, CA, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Ames
authors.affiliation: VA Central Western Massachusetts, Leeds, MA, USA.
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Copeland
authors.affiliation: Minneapolis VA Medical Center, Minneapolis, MN, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Billington
authors.affiliation: VA Southern Nevada Health Care System, Las Vegas, NV, USA.
authors.forename: U Inge
authors.initials: UI
authors.lastname: Ferguson
authors.affiliation: Comprehensive Weight Control Program, Weill-Cornell Medicine, New York, NY, USA.
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Aronne
authors.affiliation: Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wadden
authors.affiliation: Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.|Geriatric Research, Education and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA.
authors.forename: W Timothy
authors.initials: WT
authors.lastname: Garvey
authors.affiliation: Boston University School of Medicine, Nutrition and Weight Management and Nutrition and Support Service at Boston Medical Center, Boston, MA, USA.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Apovian
authors.affiliation: Health Service Research and Development, US Department of Veterans Affairs, Washington, DC, USA.
authors.forename: David
authors.initials: D
authors.lastname: Atkins
mesh_terms: D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D003226:Congresses as Topic; D004363:Drug Utilization; D006801:Humans; D009765:Obesity / Q000188:drug therapy*; D000073319:Obesity Management / Q000379:methods*; D014481:United States; D014493:United States Department of Veterans Affairs; D058014:Veterans Health
chemical_list: D019440:Anti-Obesity Agents
keywords: obesity; pharmaceutical care; veterans