Does mental health influence weight loss in adults with prediabetes? Findings from the VA Diabetes Prevention Program
Section snippets
Background
According to the National Center for Health Statistics, the prevalence of obesity among adults in the United States is approximately 40% [1]. Approximately half of the adults diagnosed with depression (43%) [2], schizophrenia (52%), and bipolar disorder (55%) are obese [3]. Obesity is associated with an increased risk of many co- morbid conditions, including some cancers, type 2 diabetes, degenerative arthritis, sleep apnea, hypertension, and cardiovascular disease, among others. Health care
Study design
This study was a secondary data analysis of the VA-DPP Clinical Demonstration Trial (VA-DPP), a non-randomized, pragmatic, prospective comparative effectiveness study of two lifestyle change interventions for obese/overweight patients with prediabetes. Patients from three VA Medical Centers (VAMCs) who met eligibility criteria were systematically assigned to either the VA-DPP or to the existing VA weight loss program (MOVE!). Every 2 months, sites assigned the first 20 eligible Veterans to
Results
A detailed consort diagram for this study has been previously published [27]. Briefly, 1850 patients were screened or attended MOVE! orientation sessions. Of the 387 Veterans who met study eligibility criteria including being pre-diabetes, 273 were assigned to the VA-DPP intervention and 114 were assigned to the MOVE! intervention. Due to missing baseline weight, one of the 114 patients assigned to the MOVE! intervention was excluded from the analytical sample (n = 386). Among the remaining 386
Discussion
In this study we compared weight loss outcomes in standard lifestyle programs offered to Veterans with SMI, AD, and No SMI/No AD. We observed a statistically significant difference in weight loss at 6 but not 12 months among Veterans with SMI, with absolute weight loss being lowest among Veterans with SMI as compared to those with AD or No SMI/No AD. These findings suggest Veterans with SMI may benefit from tailored programs which can better meet their unique health needs and/or preferences.
Financial support
This work was funded by the VA Quality Enhancement Research Initiative program through two research grants (RRP12-440 and SDP 12-549) and clinical quality improvement funding (XVA41-048). CAJ was supported by the VA Center for Clinical Management Research, Health Services Research and Development as a post-doctoral fellow at the VA Ann Arbor Healthcare System (2013-2015). TM received support from the VA Office of Academic Affiliations through the VA Health Services Research and Development
Acknowledgements
The authors thank Samantha Lindenauer for her significant contributions as a research assistant throughout the project. We also thank all the Veterans who participated in this study and their services to our country.
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