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Objective: To determine whether the presence or severity of pain is predictive of suboptimal weight loss outcomes in behavioral weight management programs. Methods: This is a secondary data analysis comparing weight loss among participants with overweight/ obesity who participated in a 12-month randomized controlled trial. Of the 481 participants randomized, 394 (81.9%) had available pain data and were categorized by Pain Type (back pain, arthritis pain, both, or neither) and Pain Severity (no pain, moderate pain, or severe pain). Dietary and physical activity outcomes were also explored. Results: High rates of moderate and severe (80.2%), and back and arthritis (72.6%), pain were observed. Linear mixed models showed significant differences in % weight loss among Pain Severity, but not Pain Type, groups. Patients with severe pain lost significantly less weight (20.1 kg, 95% CI 5 21.5, 21.2) compared to those with either moderate or no pain (21.9 kg, 95% CI 5 22.5, 21.3; 22.1 kg, 95% CI 5 23.3, 21.0, respectively). Patients with arthritis pain lost a significant amount of weight despite only minor improvements in walking distance. Conclusions: Pain severity, but not pain type, is predictive of suboptimal weight loss outcomes.

Objective: To assess for the frequency of binge eating behavior and its association with weight loss in an overweight/obese sample of veterans. Methods: This study is a secondary analysis of data from the ASPIRE study, a randomized effectiveness trial of weight loss among veterans. Of the 481 enrolled veterans with overweight/obesity, binge eating frequency was obtained by survey for 392 (82%). Results: The majority (77.6%) reported binge eating, and 6.1% reported high-frequency binge eating. Those reporting any binge eating lost 1.4% of body weight, decreased waist circumference by 2.0 cm, and had significantly worse outcomes than those reporting never binge eating who lost about double the weight (2.7%) and reduced waist circumference by twice as much (4.2 cm). The high-frequency binge group gained 1.4% of body weight and increased waist circumference by 0.3 cm. Conclusions: High rates of binge eating were observed in an overweight/obese sample of veterans enrolled in weight loss treatment. The presence of binge eating predicted poorer weight loss outcomes. Furthermore, high-frequency binge eating was associated with weight gain. These findings have operational and policy implications for developing effective strategies to address binge eating in the context of behavioral weight loss programs for veterans.

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Telemedicine-based specialty mentorship programs are highly valued by primary care-based participants, and self-reported benefits accumulate beyond 1 year of participation.