Exploring correlates of 6-month weight loss among black United States Veterans entering Veterans Health Administration behavioral weight management care

Abstract: Black United States (U.S.) veterans lose less weight than White veterans in the Veterans Health Administration (VHA) MOVE! Weight Management Program. This study identified correlates of weight loss among Black veterans in a real-world setting to 1) pilot methods and 2) generate hypotheses for future larger scale studies. We conducted an exploratory study to identify correlates of electronic health record (EHR)-derived, prospective six-month weight loss among Black VHA patients with a body mass index ≥30 kg/m2 and a first MOVE! visit (recruited 08/2022–05/2023). Of 1386 recruited, 173 veterans were screened (12.5 %), and 106 participated (7.6 %). We examined bivariate relationships of six-month weight loss with baseline social determinants of health (e.g., walkability), psychosocial factors (e.g., Everyday Discrimination Scale (EDS), posttraumatic stress disorder (PTSD)), behaviors (e.g., diet quality), and medical co-morbidity. Higher baseline weight, meeting PTSD screening criteria, and identifying as men were associated with less weight loss (ps < 0.05). Most (93 %) reported experiencing discrimination, with racial discrimination being the most common. Addressing gender- and PTSD-based barriers may help to mitigate disparities affecting Black veterans. Larger-scale studies modeled after ours but with improved recruitment methods should be conducted.

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