Evidence-Based Weight Control in the VA Health System
One of the greatest challenges for addressing obesity is delivering evidence-based weight control at a scale that will have meaningful impact. Oh, and we’d like it to be affordable.
At the 2013 Scientific Sessions of the American Diabetes Association in Chicago yesterday, a team of researchers presented data suggesting they can do just that in America’s largest health system — the Veterans Health Administration. Said lead investigator, Sandra Jackson of Emory University:
Intensive lifestyle-change programs such as the Diabetes Prevention Program [DPP] have been shown to reduce weight and prevent diabetes. However, in research studies, subjects volunteer to participate and may be highly motivated. In addition, research studies and community programs have generally involved relatively small numbers. It has been suggested that implementing lifestyle-change programs within a healthcare system could be a powerful step forward in disease prevention.
Building upon the DPP, the VA health system has implemented their own version, which they call Managing Overweight and/or Obesity in Veterans Everywhere (MOVE). Though it is modeled on the DPP, the MOVE program is different from DPP. Patients do not have to have prediabetes to enroll, they attend 8 to 12 sessions instead of 16, many providers (not a single coach) deliver the sessions, and patients set their own goals.
Jackson and colleagues analyzed data from an impressive 135,686 patients with three years of follow-up. They found a mean BMI reduction from 36.3 to 35.8 during the study, and a mean weight loss of 1.3% of body weight. Most importantly, the weight loss significantly (p<0.001) reduced the risk of developing diabetes over the three years of the study.
These data give encouragement that evidence-based weight control can be delivered in a large-scale health system, and provide meaningful health benefits.
Omaha Beach Veterans, Photograph © Garry Wilmore / flickr
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