Journal of General Internal Medicine

, Volume 32, Supplement 1, pp 11–17 | Cite as

The Obesity Epidemic in the Veterans Health Administration: Prevalence Among Key Populations of Women and Men Veterans

  • Jessica Y. Breland
  • Ciaran S. Phibbs
  • Katherine J. Hoggatt
  • Donna L. Washington
  • Jimmy Lee
  • Sally Haskell
  • Uchenna S. Uchendu
  • Fay S. Saechao
  • Laurie C. Zephyrin
  • Susan M. Frayne
Article

Abstract

Background

Most US adults are overweight or obese. Understanding differences in obesity prevalence across subpopulations could facilitate the development and dissemination of weight management services.

Objectives

To inform Veterans Health Administration (VHA) weight management initiatives, we describe obesity prevalence among subpopulations of VHA patients.

Design

Cross-sectional descriptive analyses of fiscal year 2014 (FY2014) national VHA administrative and clinical data, stratified by gender. Differences ≥5% higher than the population mean were considered clinically significant.

Participants

Veteran VHA primary care patients with a valid weight within ±365 days of their first FY2014 primary care visit, and a valid height (98% of primary care patients).

Main Measures

We used VHA vital signs data to ascertain height and weight and calculate body mass index, and VHA outpatient, inpatient, and fee basis data to identify sociodemographic- and comorbidity-based subpopulations.

Key Results

Among nearly five million primary care patients (347,112 women, 4,567,096 men), obesity prevalence was 41% (women 44%, men 41%), and overweight prevalence was 37% (women 31%, men 38%). Across the VHA’s 140 facilities, obesity prevalence ranged from 28% to 49%. Among gender-stratified subpopulations, obesity prevalence was high among veterans under age 65 (age 18-44: women 40%, men 46%; age 45-64: women 49%, men 48%). Obesity prevalence varied across racial/ethnic and comorbidity subpopulations, with high obesity prevalence among black women (51%), women with schizophrenia (56%), and women and men with diabetes (68%, 56%).

Conclusions

Overweight and obesity are common among veterans served by the VHA. VHA’s weight management initiatives have the potential to avert long-term morbidity arising from obesity-related conditions. High-risk groups—such as black women veterans, women veterans with schizophrenia, younger veterans, and Native Hawaiian/Other Pacific Islander and American Indian/Alaska Native veterans—may require particular attention to ensure that systems improvement efforts at the population level do not inadvertently increase health disparities.

KEY WORDS

veterans obesity health disparities population health women 

Supplementary material

11606_2016_3962_MOESM1_ESM.pdf (26 kb)
Online Appendix 1(PDF 25 kb)
11606_2016_3962_MOESM2_ESM.pdf (615 kb)
Online Appendix 2(PDF 614 kb)
11606_2016_3962_MOESM3_ESM.pdf (55 kb)
Online Appendix 3(PDF 54.6 kb)
11606_2016_3962_MOESM4_ESM.pdf (878 kb)
Online Appendix 4(PDF 877 kb)

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Copyright information

© Society of General Internal Medicine 2017

Authors and Affiliations

  • Jessica Y. Breland
    • 1
    • 2
  • Ciaran S. Phibbs
    • 1
    • 2
  • Katherine J. Hoggatt
    • 3
    • 4
  • Donna L. Washington
    • 3
    • 5
  • Jimmy Lee
    • 1
  • Sally Haskell
    • 6
    • 7
    • 8
  • Uchenna S. Uchendu
    • 9
  • Fay S. Saechao
    • 1
  • Laurie C. Zephyrin
    • 6
    • 10
  • Susan M. Frayne
    • 1
    • 2
  1. 1.VA HSR&D Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care SystemMenlo ParkUSA
  2. 2.Stanford University School of MedicineStanfordUSA
  3. 3.VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare SystemSepulvedaUSA
  4. 4.Department of EpidemiologyUCLA Fielding School of Public HealthLos AngelesUSA
  5. 5.David Geffen School of MedicineUniversity of California, Los AngelesLos AngelesUSA
  6. 6.United States Department of Veterans Affairs Central OfficeWomen’s Health ServicesWashingtonUSA
  7. 7.West Haven VAWest HavenUSA
  8. 8.Yale University School of MedicineNew HavenUSA
  9. 9.United States Department of Veterans Affairs Central OfficeOffice of Health EquityWashingtonUSA
  10. 10.New York University School of MedicineNew YorkUSA

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