Behavioral Treatment for Veterans with Obesity: 24-Month Weight Outcomes from the ASPIRE-VA Small Changes Randomized Trial

Background Small Changes (SC) is a weight management approach that demonstrated superior 12-month outcomes compared to the existing MOVE! ® Weight Management Program at two Veterans Affairs (VA) sites. However, approaches are needed to help graduates of treatment continue to lose or maintain their w...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of general internal medicine : JGIM 2017-04, Vol.32 (Suppl 1), p.40-47
Main Authors:	Lutes, Lesley D., Damschroder, Laura J., Masheb, Robin, Kim, Hyungjin Myra, Gillon, Leah, Holleman, Robert G., Goodrich, David E., Lowery, Julie C., Janney, Carol, Kirsh, Susan, Richardson, Caroline R.
Format:	Article
Language:	eng
Subjects:	Adult Aged Behavior Therapy - methods Body weight Body weight loss Diabetes Diabetes mellitus Diabetes Mellitus, Type 2 - complications Female Follow-Up Studies Graduates Humans Internal Medicine Male Medicine Medicine & Public Health Middle Aged Obesity Obesity - etiology Obesity - physiopathology Obesity - therapy Obesity Management - methods Original Research Overweight Patient Compliance Socioeconomic Factors Statistical analysis Treatment Outcome Veterans Weight control Weight Loss
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Background Small Changes (SC) is a weight management approach that demonstrated superior 12-month outcomes compared to the existing MOVE! ® Weight Management Program at two Veterans Affairs (VA) sites. However, approaches are needed to help graduates of treatment continue to lose or maintain their weight over the longer term. Objective The purpose of the present study was to examine the effectiveness of a second year of low-intensity SC support compared to support offered by the usual care MOVE! programs. Design Following participation in the year-long Aspiring to Lifelong Health in VA (ASPIRE-VA) randomized controlled trial, participants were invited to extend their participation in their assigned program for another year. Three programs were extended to include six SC sessions delivered via telephone (ASPIRE-Phone) or an in-person group (ASPIRE-Group), or 12 sessions offered by the MOVE! programs. Participants Three hundred thirty-two overweight/obese veterans who consented to extend their participation in the ASPIRE-VA trial by an additional year. Main Measures Twenty-four-month weight change (kg). Key Results Twenty-four months after baseline, participants in all three groups had modest weight loss (−1.40 kg [−2.61 to −0.18] in the ASPIRE-Group, −2.13 kg [−3.43 to −0.83] in ASPIRE-Phone, and −1.78 kg [−3.07 to −0.49] in MOVE!), with no significant differences among the three groups. Exploratory post hoc analyses revealed that participants diagnosed with diabetes initially benefited from the ASPIRE-Group program (−2.6 kg [−4.37 to 0.83]), but experienced significant weight regain during the second year (+2.8 kg [0.92–4.69]) compared to those without diabetes. Conclusions Participants in all three programs lost weight and maintained a statistically significant, though clinically modest, amount of weight loss over a 24-month period. Although participants in the ASPIRE-Group initially had greater weight loss, treatment was not sufficient to sustain weight loss through the second year, particularly in veterans with diabetes. Consistent, continuous-care treatment is needed to address obesity in the VA.
ISSN:	0884-8734 1525-1497