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Emotional Difficulties, Perceived Weight Loss Barriers, and Exercise in Overweight or Obese Women Veterans

Joseph N, Rose DE, Bean-Mayberry BA, Farmer MM, Washington DL. Emotional Difficulties, Perceived Weight Loss Barriers, and Exercise in Overweight or Obese Women Veterans. Poster session presented at: VA HSR&D Enhancing Partnerships for Research and Care of Women Veterans Conference; 2014 Jul 31; Arlington, VA.


Objectives: More than two-thirds of US adults and Veterans are overweight or obese (OW/OB), but relatively few Veterans utilize VA's MOVE! weight-management program. Consequently, primary care providers (PCPs) must promote weight management. To assist PCPs, we identified patient characteristics associated with perceived weight loss barriers and barriers associated with less exercise in a national sample of OW/OB women Veterans (WVs). Methods: We used the National Survey of Women Veterans (2008-2009), a national telephone survey utilizing stratified random sampling, to identify OW/OB WVs trying to lose weight (n = 1,599). We used multivariate ordered logistic regressions to examine relationships between screening positive for mood or anxiety difficulties and perceptions of the extent of weight loss interference caused by each potential barrier (using 4-point scale with 1 = not at all and 4 = a great deal) (perceived barriers). We used multivariate Poisson regressions to examine relationships between weight loss barrier perceptions and days/week of moderate exercise. Analyses controlled for age, race/ethnicity, working status, income, education, and cardiovascular disease (CVD) and non-CVD physical conditions. Results: OW/OB WVs who screened positive for depression (aOR = 2.34; 95%CI:1.04-5.28) or a CVD-related condition (aOR = 2.04; 95%CI:1.10-3.79) more highly perceived lack of determination as a weight loss barrier. Those who screened positive for depression (aOR = 4.69; 95%CI:2.11-10.43), anxiety (aOR = 3.03; 95%CI:1.47-6.25), or a non-CVD condition (aOR = 2.04; 95%CI:1.03-4.03) more highly perceived excessive emotional triggers as a weight loss barrier. OW/OB WVs reported 2.3 mean number of days/week of moderate exercise. Those who more highly perceived lack of determination to lose weight (IRR = 0.87; 95%CI:0.78-0.97), insufficient time to exercise (IRR = 0.88; 95%CI:0.79-0.99), and/or health conditions limiting exercise (IRR = 0.91; 95%CI:0.83-0.99) as barriers reported fewer days of moderate exercise. Those with higher income (IRR = 1.09; 95%CI:1.01-1.19) reported more days of moderate exercise. Conclusions: Among OW/OB WVs, mental and physical health factors influenced perceived weight loss barriers. Additionally, perceived barriers, physical conditions and low income were associated with less exercise. Impacts: We identified mental and physical health issues that potentially drive WVs' perception of weight loss barriers and exercise. These results can inform PCPs' efforts at barrier identification and problem solving, a process which has been shown to increase exercise.

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