# Measuring the Longitudinal Relationshipsbetween Obesity, Weight Management Intervention, and Medical Expenditure

> **NIH VA I01** · DURHAM VA MEDICAL CENTER · 2020 · —

## Abstract

The prevalence of obesity among adults is stabilizing after decades of unrelenting increases and about
68% of Veterans are considered either overweight or obese. Obesity is the second leading cause of
preventable deaths in the US and is associated with a wide range of diseases, such as hypertension, type 2
diabetes mellitus, coronary heart disease, and osteoarthritis. These clinical risks lead obese patients to incur
disproportionately high health expenditures. In 2008, annual health expenditures attributable to obesity were
estimated to be $147 billion, concentrated among morbidly obese patients. In 2013, 28.2% of overall health
expenditures for adults was incurred for obesity-associated care.
 Currently, three types of weight management interventions are available to overweight and obese VA
patients: behavioral lifestyle counseling, pharmacotherapy and bariatric surgery. The most widely used of
these interventions is behavioral counseling through the MOVE! program. Despite the widespread adoption of
MOVE! as a first line treatment for obesity in VA, MOVE! participation has been associated with modest short-
term weight loss and evidence is absent regarding the clinical and economic effectiveness of MOVE! beyond a
12-month follow-up. No prior VA studies have examined the natural history of weight gain, long-term
expenditures of normal weight, overweight and obese Veterans, or changes in weight and expenditures
attributable to MOVE!. It is important to understand longitudinal (20-year) patterns of VA healthcare
expenditures by BMI progression to characterize the long-run scope of the problem of obesity in VA. Such
results will then provide significant context for evaluating the health and economic effectiveness of MOVE!
participation. Taken together, the four specific aims will enable an examination of impact of MOVE! on Veteran
outcomes in the context of VA's overall population-level weight management strategy on eligible Veterans:
Aim 1: Identify latent classes of different BMI progression trajectories between 2000-2019.
Aim 2: Estimate differences in long term VA expenditures between latent BMI classes.
Aim 3: Identify the average treatment effect of MOVE! and characteristics of Veterans who experience the
greatest weight reductions following MOVE! participation.
Aim 4: Identify the average treatment effect of MOVE! on expenditures and characteristics of Veterans who
experience the greatest reduction in VA expenditures following MOVE! participation.
Next Steps: The examination of 20-year expenditures associated with obesity and differential effects of
MOVE! responds to one of the top four strategic goals identified in the VA FY 2018-2024 Strategic Plan by
informing approaches to focus resources more efficiently. This study also addresses HSR&D's cross-cutting
priority of business case and policy analysis and the Healthcare Informatics priority through the analysis,
validation, and application of Big Data sources to improve individual and popul...

## Key facts

- **NIH application ID:** 9952126
- **Project number:** 5I01HX002697-02
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** MATTHEW L MACIEJEWSKI
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-06-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9952126

## Citation

> US National Institutes of Health, RePORTER application 9952126, Measuring the Longitudinal Relationshipsbetween Obesity, Weight Management Intervention, and Medical Expenditure (5I01HX002697-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9952126. Licensed CC0.

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