A System-Level Approach to Overweight and Obesity in the Veterans Health Administration

Authors

Susan D. Raffa, VHA National Center for Health Promotion and Disease Prevention
Matthew L. Maciejewski, Duke University
Lindsey E. Zimmerman, VA Palo Alto Health Care System
Laura J. Damschroder, VA Ann Arbor Center for Clinical Management Research
Paul A. Estabrooks, University of Nebraska Medical CenterFollow
Ronald Ackermann, Northwestern University Feinberg School of Medicine
Adam G. Tsai, University of Colorado School of Medicine
Trina Histon, Kaiser Permanente Care Management Institute
Michael G. Goldstein, National Center for Health Promotion and Disease Prevention

Date of this Version

2017

Document Type

Article

Citation

Journal of General Internal Medicine 32(Suppl 1):S79–S82 DOI: 10.1007/s11606-016-3948-z

Comments

U.S. government work.

Abstract

Healthcare systems are challenged by steady increases in the number of patients who are overweight and obese. Large-scale, evidence-based behavioral approaches for addressing overweight and obesity have been successfully implemented in systems such as the Veterans Health Administration (VHA). These population-based interventions target reduction in risk for obesity-associated conditions through lifestyle change and weight loss, and are associated with modest weight loss. Despite the fact that VHA has increased the overall reach of these behavioral interventions, the number of high-risk overweight and obese patients continues to rise. Recommendations for weight loss medications and bariatric surgery are included in clinical practice guidelines for the management of overweight and obesity, but these interventions are underutilized. During a recent state of the art conference on weight management held by VHA, subject matter experts identified challenges and gaps, as well as potential solutions and overarching policy recommendations, for implementing an integrated system-wide approach for improving population-based weight management.