Obesity prevalence among veterans at Veterans Affairs medical facilities

Das, Subinoy; Kinsinger, Linda; Yancy, William S.; Wang, Anthea; Ciesco, Eileen; Burdick, Mary B.; Yevich, Steven J.

doi:10.1016/j.amepre.2004.12.007

Cited by 176 publications

(141 citation statements)

References 16 publications

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“…This contrasts to Active Duty service in the U.S. Armed Forces, which involves jobs that are physical in nature and often includes regimented daily exercise. Additionally, the burden of medical morbidity and pain in the veteran population may limit physical activity in OIF/OEF veterans using VA, because these veterans have been shown to represent a lower socioeconomic group, have greater comorbidity, and have a greater prevalence of overweight and obesity than veterans not using VA [1][2][3][4][5][6][7][33][34]. The frequency of free-text responses indicating pain, depression, or disability in place of a favorite physical activity (n = 24) likely underrepresents the true prevalence, but taken together with the large percentage of participants endorsing pain or health as a limitation for physical activity (52% and 39%, respectively), it would be consistent with this national trend among VA users ( Table 3).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, veterans receiving healthcare services from the Department of Veterans Affairs (VA) have a greater prevalence of obesity than the general public [3][4] as well as veterans not using VA services [2,4]. In comparison with the general public and veterans not using the VA, veterans using VA services have also been shown to self-report poorer health [4][5][6]; are more likely to be physically inactive [2]; and are more likely to carry one or more chronic diagnoses such as hypertension, hypercholesteremia, and diabetes [2,4,[6][7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Physical activity in postdeployment Operation Iraqi Freedom/Operation Enduring Freedom veterans using Department of Veterans Affairs services

Buis¹,

Kotagal²,

Porcari³

et al. 2011

JRRD

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Physical activity in postdeployment Operation Iraqi Freedom/Operation Enduring Freedom veterans using Department of Veterans Affairs services

Buis¹,

Kotagal²,

Porcari³

et al. 2011

JRRD

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“…Obesity also contributes to the disablement process and complicates rehabilitation [7][8][9]. In the Veterans Health Administration (VHA), overweight and obese veterans comprise the majority of the patient population and have high rates of disability and generally poor health [10]. Use of existing data collected during routine clinical encounters can potentially provide important information about obesity and its outcomes.…”

Section: Introductionmentioning

confidence: 99%

VHA Corporate Data Warehouse height and weight data: Opportunities and challenges for health services research

Noël¹,

Copeland²,

Perrin³

et al. 2010

JRRD

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Abstract-Within the Veterans Health Administration (VHA), anthropometric measurements entered into the electronic medical record are stored in local information systems, the national Corporate Data Warehouse (CDW), and in some regional data warehouses. This article describes efforts to examine the quality of weight and height data within the CDW and to compare CDW data with data from warehouses maintained by several of VHA's regional groupings of healthcare facilities (Veterans Integrated Service Networks [VISNs]). We found significantly fewer recorded heights than weights in both the CDW and VISN data sources. In spite of occasional anomalies, the concordance in the number and value of records in the CDW and the VISN warehouses was generally 97% to 99% or greater. Implausible variation in same-day and same-year heights and weights was noted, suggesting measurement or data-entry errors. Our work suggests that the CDW, over time and through validation, has become a generally reliable source of anthropometric data. Researchers should assess the reliability of data contained within any source and apply strategies to minimize the impact of data errors appropriate to their study population.

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“…The epidemiologic data and medical burden of excess weight is no less significant among U.S. Veterans. Several recent studies of overweight/obesity have indicated high rates in the Veteran population [6][7][8][9]. Almond et al reported that 73.3% of male Veterans had excess weight (BMI≥25) and 25.3% were obese (BMI≥ Policy: VHA policy should support the development of more intensive weight management intervention strategies that complement MOVE!…”

Section: Introductionmentioning

confidence: 99%

“…30); rates in female Veterans were 53.6% and 21.2%, respectively [7]. In a sample of Veterans utilizing the Veterans Health Administration (VHA), rates of overweight/obesity were comparable for male Veterans (73% and 32.9%) and slightly higher for female Veterans (68.5% and 37.4%) [8]. The projected prevalence of obesity-related illnesses and their resulting costs are predicted to be among the highest concerns for the VHA in the coming decades.…”

Section: Introductionmentioning

confidence: 99%

MOVE! multidisciplinary programs: Challenges and resources for weight management treatment in VHA

Rosenberger

Ruser

Kashaf

2011

Behav. Med. Pract. Policy Res.

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The MOVE! program has been a successful weight management and physical activity initiative from the Veteran's Health Administration. While it embraces a multicomponent approach to weight management, local facilities have primarily focused on the implementation of delivery of MOVE! educational materials to groups or individuals. We discuss additional MOVE!-related weight management efforts within VHA that reflect treatment strategies beyond delivery of these educational materials. First, we present a case study that highlights the special challenges associated with the Veteran overweight/ obese population. Second, we describe the implementation of our local, multidisciplinary, individualized weight management clinic as an example of on-the-ground provision of a higher treatment intensity program as part of MOVE!'s multicomponent model. Third, we present program outcomes and consider challenges to program sustainability. KEYWORDSObesity, Overweight, Weight loss, Weight management, Primary care, Veterans CASE PRESENTATIONA 60-year-old white male Veteran with diabetes, hypertension, long-standing depression, and knee osteoarthritis presents to a VA multidisciplinary weight loss clinic upon referral by his primary care physician. He has already attended MOVE! educational group visits presenting information on nutrition, physical activity, and behavioral changes necessary for weight management and has made some changes but is frustrated that he has lost only 2 pounds. He has struggled with his weight for over 20 years with a few pounds gained per year, until it accelerated to 30 pounds gained over the past several years with the initiation of insulin therapy and starting an antidepressant. His current weight is 240 pounds with a body mass index (BMI) of 42 and waist circumference of 52 in. He has pain in both knees and reports that his pain score is a six out of ten. The Veteran is retired and has a limited budget for food. He has hypoglycemia several times a week and believes that it is necessary to drink juice and snack on peanut butter crackers frequently in order to prevent low blood sugars. He also endorses daytime fatigue, snoring, and mentions that his wife has noted that at times he stops breathing while he is sleeping. He limits his walking due to knee pain but reports more walking in the past month accompanied by exertional shortness of breath. He has a past diagnosis of major depression. The Veteran's medications include 70/30 insulin 55u twice a day, hydrochlorothiazide/lisinopril, amlodipine, sertraline, simvastatin, and aspirin. His recent labs include normal thyroid testing and diabetes that is only moderately well-controlled. BACKGROUNDObesity is recognized as an independent predictor of mortality [1,2] as well as a risk factor for countless other medical conditions including congestive heart failure, cancer, osteoarthritis, sleep apnea, metabolic syndrome, and diabetes [3][4][5]. Estimates show that obesity accounts for nearly 400,000 deaths annually [4]. The epidemiologic data and medical bur...

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Obesity prevalence among veterans at Veterans Affairs medical facilities

Cited by 176 publications

References 16 publications

Physical activity in postdeployment Operation Iraqi Freedom/Operation Enduring Freedom veterans using Department of Veterans Affairs services

Physical activity in postdeployment Operation Iraqi Freedom/Operation Enduring Freedom veterans using Department of Veterans Affairs services

VHA Corporate Data Warehouse height and weight data: Opportunities and challenges for health services research

MOVE! multidisciplinary programs: Challenges and resources for weight management treatment in VHA

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