VA researchers are showing that the one-two punch of medication plus lifestyle changes helps Veterans achieve their weight loss goals.

‘One-two punch of medication plus lifestyle changes helps Veterans with weight loss.’ Dr. Jose Aleman is director of the NY-MOVE! Endocrinology Weight Management Clinic at VA NY-Harbor Healthcare System. He is pictured with a medical student, Laetitia Zhang. (Photo by Michael Drake, VA NY-Harbor.)

You’ve tried to do everything right. You’ve passed on the Buffalo chicken wings on poker night. You’ve cut back on alcohol and switched to light beer. You’ve even joined the local gym. Nothing seems to work—those extra 50 lbs. won’t budge.

Well, you’re not alone.

Obesity is a chronic disease where the pathways that control how much we eat can lead us to take in too many calories and accumulate excess fat that promotes health complications, says Dr. Jose O. Aleman, an endocrinologist at the VA New York Harbor Healthcare System, Manhattan Campus. When coupled with easy access to poorly nutritious food, individuals with obesity often struggle with their weight loss goals.

“I tell my Veteran patients that even though 10 pounds doesn’t sound like a large amount of weight, it is the type of weight loss that tends to be sustainable,” Aleman said.

Physician supports use of weight-loss medication

Aleman is the director of the NY-MOVE! Endocrinology Weight Management Clinic at the NY-Harbor VA. He also leads clinical research to find the best ways to help Veterans reach a healthier weight.

Aleman and his team published a study in the journal Obesity that examined the effectiveness of pharmacotherapy – weight-loss medication – when combined with lifestyle changesThe study confirmed the benefits of medication but noted significant variability among individual patients. The researchers found the most effective weight-loss agents were phentermine/topiramate (Qsymia), followed by liraglutide (Saxenda) and orlistat (Alli).

“Both at the local and national level, we found obesity pharmacotherapy is effective in changing the trajectory of weight in Veterans in addition to lifestyle changes,” said Aleman.

The study examined data for 43 local Veterans who were enrolled in the NY-MOVE! weight-loss program and who were prescribed an obesity medication. The most commonly prescribed medications at the local level were metformin (Glucophage), liraglutide, and phentermine/topiramate.

Researchers review records of nearly 600,000 Veterans

The research team wanted to know how well the local group of Veterans were doing in comparison to the larger VA population. Aleman’s team reviewed nearly 578,000 VA health records nationwide for Veterans who had an obesity diagnosis or metformin prescription in their VA health record. Metformin is a commonly prescribed diabetes drug that can help with weight loss.

In comparison to the New York group, the national group of Veterans had greater numbers of men, were less racially diverse, and were later in their disease progression – 86% had type 2 diabetes, compared with 44% of the local group.

On average, the New York group lost 8.8 pounds over the initial six-month period. Over a one-year period, 75% of the national group lost between 5.5 to 11 pounds after starting weight-loss medication.

Don’t do it alone

Diet and exercise are typically first-line treatments for weight loss. In the case of Veterans, Aleman says excess weight may be related to the lack of structure they encounter after their military service is over. That is why the VA-MOVE! Weight Management Program is designed to reintroduce structure for Veterans.

VA-MOVE! makes use of behavioral interventions, like group counseling, with lifestyle guidance and nutritional education. The program offers Veterans a range of tools – for example, food journals, a mobile app to track diet and exercise, and, in some cases, access to gyms.

Studies have shown that participants in VA-MOVE! typically achieve modest, short-term weight loss – with an average of 0.28 lbs. to 7.3 lbs. at the one-year mark. Aleman says a typical weight-loss goal might be losing 5% of your baseline weight within 3 to 6 months. For a 200-pound Veteran, that would be 10 pounds.

“I tell my Veteran patients that even though it doesn’t sound like a large amount of weight, it is the type of weight loss that tends to be sustainable. It will also help with health complications, which is really the goal,” said Aleman.

More Information

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10 Comments

  1. Erica Sprey August 12, 2021 at 2:13 pm

    Thank you for your comments and interest. If you would like to find out more about VA weight-loss programs and therapy, please speak to your primary care physician.
    –Erica Sprey, author

  2. Kim Shuler August 12, 2021 at 8:59 am

    Hi Rod, please do some reading on menopausal female hormones and low thyroid hormones. Even when medication is taken to “resolve” these issues, the weight doesn’t come off. In fact, it continues to creep on, three to five pounds a year. It doesn’t happen to every woman, but it happens to many of us.

  3. Lavon Strouble August 11, 2021 at 1:22 am

    I would like to know more about loss I’m a woman veteran love to lose weight

  4. Pat Fox August 10, 2021 at 10:16 pm

    In the last 12 months I have lost 35 lbs without medications. I do not deprive myself of ALL the sweets I crave, I am just trying to be more conscious of the foods that I do choose.
    I had been on saxenda the previous year with only 10 lbs of weight loss but was taken off of it due to some loss of kidney function.
    Of course I would love to loose the next 100 lbs faster, I just don’t know how.

  5. James Robbins GSM2 USN RET August 10, 2021 at 10:00 pm

    I’ve been on Phentermine for about a year. Went from 240 to my lowest of 183. I have rebounded a bit to 195 but I’m definitely a lot better off than 240. I think you still have to have some desire to go along with the med though too. It’s not gonna carry you the entire way. Hence my rebound. @Rod, that’s where you’re right. @Edward that’s where you still gotta get the mindset right. I still struggle with that part myself cuz food tastes good. The meds help though. I don’t start hungry all day anymore. I need to show this article to the Primary Care I was just switched to at the VA, and then immediately requested to be assigned to a new doc after meeting him, cuz the guy was a moron and said these meds don’t do anything. Lol

  6. Barkley Bell August 10, 2021 at 6:32 pm

    Weight can be lost with proper diet alone. At five feet and seven inches tall, I gain weight shortlly after a 20-year retirement from the U.S. Air Force. I weighed 212 pounds when I decided to do something. So, I joined a local Weight Watcher Group. In four months I was down to 165 pounds! I had lost 55 pounds in just 4 months. I never once cheated on the food intake management program. I did not use any pills. I stayed with the program for about a year and then stopped attending meetings and some weight came back. My point is just reducew intake calories and the weight will come off.

  7. Kevin Burns August 10, 2021 at 3:35 pm

    Good info

  8. Scarlett Barbee August 10, 2021 at 2:51 pm

    @ Rod Tompson…”your belief”???? is yours and yours alone and about as empirical an observation as that of a flat-earther. You are opinionated and have no empathy for others. Since this worked for you, it must work for everyone else…otherwise, s/he must not want it enough, be lazy, mentally weak…damn all scientific evidence to the contrary to hell…like when I am standing there starving, ready to go crazy with the mental need and impulses my brain is sending…but again, it is just me not wanting it enough…pls, stop giving your ill-advised opinion/beliefs…they are useless and don’t ever be a counselor/therapist or any occupation where helping others in any shape or fashion is involved…

  9. Edward Rhodes August 10, 2021 at 12:17 am

    None of that crap worked for me. I’m still binge eating more than ever.

    • Rod Thompson August 10, 2021 at 9:03 am

      I believe that if you want to lose weight you can. I have dropped from 259 the first of March of this year to 223 today August 10th 2021 without the help of pills.

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