Bipolar Disorder Influences Weight Loss in the Move!® Programs for Veterans

Janney CA, Owen R, Bowersox NW, Ratz D, Kilbourne AM, Richardson CR. Bipolar Disorder Influences Weight Loss in the Move!® Programs for Veterans. Paper presented at: International Society for Bipolar Disorders Annual Conference; 2015 Jun 4; Toronto, Canada.

AIMS: To investigate the relationship between bipolar disorder (BD) and weight loss in overweight/obese veterans enrolled in MOVE! , a national weight loss program available throughout the Veterans Health Administration (VHA) health care system. METHODS: MOVE! participants with at least 2 MOVE! visits enrolled during Fiscal Years 2008-2012, who had BMI > = 25 kg/m2, and who were 18-69 years of age (n = 46772) were included in these analyses. VHA administrative data identified Veterans with BD (ICD-9-CM codes = 296.0 - 296.1, 296.4 -296.89, 301.11, 301.13), schizophrenia/schizoaffective disorders (SZO)(ICD-9-CM = 295) or no mental health disorders (MHD). Weight changes at 6- and 12-months by MHD diagnosis were modeled using repeated measures controlling for demographics, and medical and psychiatric comorbidities. RESULTS: BD was diagnosed in 3529 (7.6%) veterans. At baseline enrollment, veterans with BD (240.8+48.0lbs.) or SZO (241.0+47.4 lbs., n = 2315) weighed less than those with no MH (248.2+ 49.6 lbs., n = 40,928)(p < 0.01). Over the one year evaluation period, the pattern of weight loss was statistically different between veterans with BD compared to veterans with no MHD (p < 0.01). At 6-months, average weight loss among veterans with BD (-3.0+0.2 lbs.) was less than those with no MHD (-3.6+0.1 lbs., p < 0.01). Between 6- and 12-months, veterans with BD continued to lose weight, on average, while those with no MHD were regaining weight, on average. Overall, average weight loss was modest for veterans with BD (-3.8+0.3 lbs.), SZO (-3.5+0.3 lbs.), or no MHD (-3.1+0.1lbs.) at 12 months (p < 0.01). Clinically significant weight loss ( > 5% from baseline) at 12-month was achieved by 23.6%, 23.8%, and 18.9% of veterans with BD, SZO, or no MHD, respectively (p < 0.01). CONCLUSION: These findings highlight that modest weight loss for individuals with BD or SZO is obtainable within a nationally implemented weight loss intervention. Veterans with BD or SZO exhibited delayed weight loss at 6-months but continued to lose weight at 12-months compared to veterans with no MHD.