Development of a Tailored Behavioral Weight Loss Program for Veterans With PTSD (MOVE!+UP): A Mixed-Methods...

Area of Science:

• Clinical Psychology
• Behavioral Medicine
• Public Health

Background:

• Veterans with post-traumatic stress disorder (PTSD) often face challenges in weight management programs.
• Existing Veterans Affairs (VA) weight management programs, like MOVE!, show reduced efficacy for individuals with PTSD.
• This necessitates the development of tailored interventions to address the unique needs of this population.

Purpose of the Study:

• To iteratively develop and pilot a modified weight management program, MOVE!+UP, specifically for overweight Veterans with PTSD.
• To assess the feasibility, acceptability, and preliminary effectiveness of the MOVE!+UP intervention.

Main Methods:

• A single-arm, pre-post pilot study was conducted from 2015-2018.
• The MOVE!+UP program underwent iterative modifications across five development cohorts (n=31) before finalizing.
• The final intervention involved 16 two-hour in-person group sessions, co-led by a psychologist and peer counselor, including general weight loss support, PTSD-specific cognitive-behavioral skills, and physical activity components, alongside two individual dietitian visits.

Main Results:

• Initial development cohorts (n=31) did not achieve significant weight loss (mean change = -1.8 lbs, P = .29).
• The final, refined MOVE!+UP intervention (n=8) demonstrated high participant satisfaction.
• Significant improvements were observed in weight loss (mean change = -14 lbs, 71% lost ≥5% baseline weight) and PTSD symptom severity (mean change = -17.9, P < .05) in the final cohort.

Conclusions:

• The comprehensive, 16-week, in-person, cofacilitated MOVE!+UP program is acceptable for Veterans with PTSD.
• Iterative development resulted in a patient-centered intervention that shows promise for improving weight and PTSD symptoms.
• Further research is warranted to validate these findings in larger, controlled trials.