# Teaching Obesity Treatment Options to Adult Learners (TOTAL): A Multi-site RCT

> **NIH VA I01** · WM S. MIDDLETON MEMORIAL VETERANS HOSP · 2022 · —

## Abstract

Background: Nearly 80% of Veterans meet criteria for overweight (body mass index [BMI] of 25-29.9 kg/m2) or
obesity (BMI≥30). VA offers three evidence-based obesity treatments at little to no cost to Veterans: MOVE! (to
improve dietary intake and physical activity through behavioral modification); obesity medications; and bariatric
surgery, but all are significantly underutilized: <10% of Veterans with obesity participate in MOVE!; 2% receive
obesity medications; and 0.3% of those who meet BMI criteria for bariatric surgery (BMI≥35) undergo it. There
is an urgent need to increase use of all three treatments to improve Veteran health.
Significance/Impact: Nearly 4,000,000 Veterans meet BMI criteria for overweight/obesity. It is essential that
Veterans with overweight/obesity are aware of the three treatment options and are motivated to pursue them.
Currently, no interventions in VA seek to increase use of all three evidence-based obesity treatment options for
Veterans not currently participating in MOVE!. The TOTAL intervention (Teaching Obesity Treatment Options to
Adults Learners), if effective, would increase obesity treatment initiation for Veterans, lead to greater weight loss,
and improve quality of life. Given that TOTAL is deliverable via VA telemedicine, it could be implemented
throughout the VA healthcare system without requiring significant resources and could be integrated into the
existing VA behavioral weight management program, MOVE!.
Innovation: The research in this proposal would be the first adequately powered RCT in VA testing an
intervention to increase use of all three evidence-based obesity treatments: MOVE!, obesity medications, and
bariatric surgery. It would leverage the power of the VA electronic health record and would improve access to
care by expanding use of a recently developed telemedicine technology – VA Video Connect (VVC) – which was
developed by VA researchers. It could be implemented and disseminated efficiently within VA given that MOVE!
is available at every VAMC and is supported by NCP.
Specific Aims: Aim 1: Compare the effectiveness of TOTAL vs. usual care for increasing obesity treatment
initiation among Veterans with overweight/obesity who are not participating in MOVE!; Aim 2: Compare the
effectiveness of TOTAL vs. usual care for increasing sustained MOVE! participation, receipt of an obesity
medication prescription or bariatric surgery referral, and weight loss; Aim 3: Inform future dissemination efforts
of TOTAL via interviews with key stakeholders, a “Reach” analysis, and cost analysis.
Methodology: Study population: Veterans at two VAMCs, age 18-75 with a BMI ≥30 or 27-29.9 + an obesity-
related comorbidity who have not had a MOVE! visit within the past 12 months and thus are not participating in
obesity treatment will participate in the RCT; Intervention: The TOTAL intervention consists of an 18-minute
obesity treatment educational video and three motivational sessions (all delivered via VA Video Co...

## Key facts

- **NIH application ID:** 10424975
- **Project number:** 1I01HX003354-01A2
- **Recipient organization:** WM S. MIDDLETON MEMORIAL VETERANS HOSP
- **Principal Investigator:** Luke M Funk
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-05-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10424975

## Citation

> US National Institutes of Health, RePORTER application 10424975, Teaching Obesity Treatment Options to Adult Learners (TOTAL): A Multi-site RCT (1I01HX003354-01A2). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10424975. Licensed CC0.

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