College of Psychology Theses and Dissertations

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Date of Award

1-1-2012

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Psychology (PhD)

Department

Center for Psychological Studies

First Advisor

Barry Nierenberg

Second Advisor

Christian DeLucia

Third Advisor

Jason Dahn

Keywords

obesity, overweight, weight loss intervention, women veterans

Abstract

The aim of the current study is to understand the health trajectory of female veterans who participated in a VHA sponsored weight management program and explore possible barriers to sustained weight loss and improved metabolic functioning over time. Obesity

is a major health concern for discharged service members and women veterans in particular are faced with an increasing prevalence of obesity at a younger age with obese ethnic minorities posing the greatest health risk over time. The current study measured body mass index (BMI), triglycerides, and total cholesterol in female participants enrolled in the MOVE! ® Weight Management Program for Veterans at the Miami VAHS from 2005-2008 (N = 170). The sample was derived from an archival data set and

participants were predominantly non-Hispanic Black (NHB) (n = 93, 54.7%), with a mean age of 48.26 (SD = 11.77) and BMI of 34.97 (SD = 6.61) at program entry. Medical information was gathered as part of routine primary care and participants were not asked to provide additional information. Multilevel modeling was utilized to measure change in BMI, triglycerides, and total cholesterol across seven time points before and after MOVE! ® participation. For the piecewise model, results showed a positive linear growth pattern in BMI prior to program enrollment, SE = .12, p < .001, and a negative linear pattern post-intervention, SE = .08, p = .05. For the continuous models, significant differences in triglycerides were observed between ethnic groups at program entry, but overall triglycerides did not significantly change over time. A significant negative linear effect was found for total cholesterol, SE = 1.08, p < .001. Age was found to be a

significant negative predictor of triglycerides, SE = .003, p = .008, and total cholesterol, SE = .27, p = .003. VA user status, small sample size, and other extraneous lifestyle factors not directly measured in the current study may explain the lack of significant differences in BMI found between ethnic groups relative to literature on weight loss

outcomes. Additionally, BMI in women may underestimate their total fat, which for the present study may explain why larger improvements in metabolic functioning were not observed. Future designs may consider measuring waist circumference to understand the

complex relationship between total fat distribution and markers for poor health and utilizing a tailored approach to weight management.

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