Weight loss and incidence of XXXX with the Veterans Health Administration MOVE! lifestyle change programme: an observational study.

@entity1 @entity353 @entity28 @entity6 @entity413
BACKGROUND: Programmes for lifestyle change are aimed at improving health but little is known about their effectiveness in clinical settings. The Veterans Health Administration (VA) MOVE! lifestyle change programme is the largest in the USA. We investigated whether participation in MOVE! is associated with reduced incidence of @entity6 . METHODS: We did a retrospective observational analysis of data from VA databases in overweight @entity1 and @entity28 @entity1 with a @entity353 who had undergone at least 3 years of continuous outpatient care in 2005-12. We used generalised estimating equations to assess characteristics associated with MOVE! participation, and Cox's proportional hazards regression to analyse the association between participation and @entity6 incidence. FINDINGS: Of 1  8 million eligible individuals, 238   540 (13%) participated in the MOVE! programme. 19   367 (1% overall, 8% of @entity1 ) met criteria for intense and sustained participation (at least eight sessions within 6 months over at least a 4-month span), which was associated with greater @entity353 at 3 years than low-intensity or no participation (-2  2% vs -0  64% or 0  46%). Compared with non-participation, incidence of @entity6 was reduced by intense and sustained participation (hazard ratio 0  67, 95% CI 0  61-0  74) and low-intensity participation (0  80, 0  77-0  83) in MOVE!. These patterns were consistent across sex, ethnic origin, and age. Participation was most beneficial in @entity1 with high BMI or high random @entity413 concentrations at baseline (both pinteraction<0  0001). INTERPRETATION: Participation in the MOVE! programme was associated with @entity353 and reduced incidence of @entity6 , but the rate of participation was low and, therefore, selection bias could have exaggerated these effects. FUNDING: US Department of Veterans Affairs, National Institutes of Health.
