Mental health and behavioral weight loss: 24-month outcomes in Veterans.
Individuals with mental health (MH) disorders have an increased risk of being overweight/obese; however research on behavioral weight loss interventions has been limited. A priori hypothesis was that Veterans with serious mental illness (SMI) and/or affective disorders (AD) would lose significantly less weight and have a different pattern of weight loss than Veterans without these diagnoses.



Secondary data analysis of ASPIRE-VA study, three-arm randomized, effectiveness weight loss trial among Veterans (n=409) categorized by MH diagnoses: 1) SMI, 2) AD without SMI, or 3) No SMI/No AD. Linear mixed-effects model analyzed weight changes from baseline thru 24 months.



SMI and AD were diagnosed in 10% (n=41) and 31% (n=125). Participants attended approximately 15 sessions from baseline to 24 months. On average, participants lost a modest amount of weight over 24 months regardless of MH diagnosis. Longitudinally, no statistically significant differences were found in weight loss patterns by MH diagnosis. Unadjusted average weight loss (kg) was 1.6±4.0 at 3 months (n=373), 1.9±6.5 at 12 months (n=361), 1.5±7.8 at 18 months (n=289), and 1.4±8.0 at 24 months (n=279).



ASPIRE-VA study was not designed or powered to detect weight loss differences among MH diagnostic groups.



Veterans achieved and maintained modest weight loss, through 24 months, with the three behavioral weight loss interventions. Contrary to our hypotheses, the amount and pattern of weight loss did not differ by MH diagnosis. Greater inclusion of individuals with MH diagnoses may be warranted in behavioral weight loss interventions not specifically tailored for them.
VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105, United States; Michigan State University College of Human Medicine - Midland Regional Campus Center, 4611 Campus Ridge Drive, Midland, MI 48670, United States. Electronic address: carol.janney@hc.msu.edu.
Carol A
CA
Janney
Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; VA Connecticut Healthcare System, PRIME Center/11ACSLG, 950 Campbell Avenue, West Haven, CT 06516, United States. Electronic address: Robin.Masheb@Yale.edu.
Robin M
RM
Masheb
Department of Psychology, University of British Columbia Okanagan, 3187 University Way, Kelowna, BC, Canada V1V 1V7. Electronic address: lesley.lutes@ubc.ca.
Lesley D
LD
Lutes
VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105, United States. Electronic address: Rob.Holleman@va.gov.
Robert G
RG
Holleman
VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105, United States; Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, MI, United States. Electronic address: myrakim@umich.edu.
Hyungjin Myra
HM
Kim
VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105, United States. Electronic address: Leah.Gillon@va.gov.
Leah R
LR
Gillon
VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105, United States. Electronic address: Laura.Damschroder@va.gov.
Laura J
LJ
Damschroder
VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105, United States; Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, MI, United States. Electronic address: caroli@umich.edu.
Caroline R
CR
Richardson
D000328:Adult; D001521:Behavior Therapy; D001835:Body Weight; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications*; D009765:Obesity / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D014481:United States; D014728:Veterans; D015431:Weight Loss
Anxiety; Behavioral weight loss; Depression; SMI; Small changes