Geographic Variation in Obesity, Behavioral Treatment, and Bariatric Surgery for Veterans.

Maciejewski ML, Arterburn DE, Berkowitz TSZ, Weidenbacher HJ, Liu CF, Olsen MK, Funk LM, Mitchell JE, Smith VA. Geographic Variation in Obesity, Behavioral Treatment, and Bariatric Surgery for Veterans. Obesity (Silver Spring, Md.). 2019 Jan 1; 27(1):161-165.

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Abstract:

OBJECTIVE: This study aims to describe geographic variation in veterans' prevalence of obesity, participation in Veterans Health Administration's behavioral weight management program (MOVE!), and receipt of bariatric surgery in fiscal year (FY) 2016. METHODS: In this retrospective cohort study of veterans with obesity who received Veterans Health Administration care in FY2016, electronic health record data were obtained on weight, height, outpatient visits to the MOVE! program, and bariatric surgeries. For each Veterans Integrated Service Network (VISN) region, the prevalence rate of veterans with obesity (BMI   30 kg/m ), MOVE! participation rates, and bariatric surgery rates are presented. RESULTS: The prevalence of obesity in veterans ranged from 30.5% to 40.5% across VISNs in FY2016. MOVE! participation among veterans with obesity was low (2.8%-6.9%) across all VISNs, but veterans with class II and III obesity (BMI   35) had higher MOVE! participation rates (4.3%-10.8%) than veterans with class I obesity. There was 20-fold variation across VISNs in receipt of bariatric surgery among veterans with BMI   35, ranging from 0.01% to 0.2%. Among veterans with BMI   35 participating in MOVE!, there was 46-fold variation in bariatric surgery provision, ranging from 0.07% to 3.27%. CONCLUSIONS: Despite veterans' high prevalence of obesity, behavioral and surgical weight management participation is low and varies across regions.