Obesity is a chronic disease that usually requires long-term management. Treatment depends on weight, health conditions, functional limitations, and Veteran values and preferences.

There are three treatment options that the VA offers.

1. Weight Management Classes
2. Weight Management Medications
3. Bariatric – Metabolic Surgery

It is important to talk with your primary care provider about your weight and health goals and concerns.

Weight Management Classes

Comprehensive lifestyle interventions are programs that combine changes to habits and behaviors as well as nutrition and physical activity, with support from a health coach or other member of a health care team.

(Learn more about Comprehensive lifestyle interventions.)

VA offers a free weight management program for Veterans called MOVE! which offers classes on nutrition, physical activity and behavior change. The goal is to assist Veterans in losing 5-10% bodyweight and to make positive changes in lifestyle and health. You can schedule for the introductory MOVE! Basics of Weight Management class before committing to the full program and you do not need a consult. Day, evening and women’s groups available. Telephone and video options are also available. More detail can be found on the VA Portland MOVE! Weight Management web page.

This list of programs meet the comprehensive lifestyle intervention requirement for weight management medications and bariatric-metabolic surgery:

1. VA MOVE! Weight Management Program for Veterans
2. WW (Weight Watchers)
3. TOPS (Taking Off Pounds Sensibly)
4. HMR (Health Management Resources)
5. Optifast
6. Curves Complete

Interested in learning how to cook healthier, eat for certain health conditions, or move your body more? VA Portland offers many classes to choose from.

Learn about VA Portland's many available Nutrition Classes.

Physically active individuals sleep better, feel better, and function better. Scroll down this page to Related Resources section to learn more about VA Portland’s active movement classes.

Learn about VA Portland's Active Movement Classes.

Following a healthy eating pattern over time can help support a healthy body weight and reduce the risk of chronic disease. Scroll down this page to the Related Resources section to learn more about VA Portland’s nutrition and cooking classes.

Weight Management Medications

It is important to know there may be medications you are currently taking that may affect your weight. Some medications can make it harder to lose weight. Your provider or pharmacist can review your medications to see if there are any that may cause weight gain. You may be able to have your medication changed.

Learn more about specific medications and their effects on weight.

Although lifestyle changes alone can result in weight loss, some Veterans may need additional help. VA has several medications available to help with weight loss and diabetes management for those who qualify.

Who is a good candidate for weight management medicine?

If you are participating in a lifestyle change program but are not meeting your weight loss goal:

• And if you have a body-mass index (BMI) of 30 or greater

OR

• If your BMI is 27 or greater and you have one or more health problems (examples: high blood pressure, high cholesterol, type 2 diabetes, obstructive sleep apnea, or osteoarthritis)

Will I need other forms of treatment to help me lose weight?

Yes, weight management medications may be prescribed if a Veteran qualifies and is actively participating in a lifestyle change program that includes nutrition, physical activity and behavior counseling with a clinician. See the Weight Management Classes section above for qualifying programs.

There are specific criteria that must be met to determine if a weight management medication is a safe and appropriate treatment option. Each medication has a list of criteria that a pharmacist will review with the Veterans medical history, health conditions, medication list, etc.

Go to this VA brochure to learn about weight management medicine options. 

Keep in mind:

• Medication may need to change or stop if 3-5 percent of weight has not been lost after 12-16 weeks, if Veteran can not tolerate side effects, or if weight is gained.
• Weight loss will likely plateau around 6-9 months.
• Weight is usually regained after the medication is stopped.
• Taking the medication longer does not usually lead to more weight loss, but may help maintain weight.

If you are interested in seeing if you qualify for a weight management medication, talk to your primary care provider. You will need to be participating in a lifestyle change / weight management program before a prescription can be written.

Bariatric – Metabolic Surgery

There are different types of weight loss surgery to help people lose weight in addition to making positive lifestyle change.

Is weight loss surgery the right choice for me?

This will depend on your current health condition and risks. Veterans may be considered for surgery if their body mass index (BMI) is 30 or more and there is a health condition that may be improved with weight loss.

• Veterans with a BMI of 40 or more

• Veterans with a BMI of 35 or more that also have an obesity-related condition

(heart disease, diabetes, high blood pressure, obstructive sleep apnea, fatty liver disease, etc.)

• Veterans with a BMI of 30 or more that also have type 2 diabetes

Learn more about BMI and calculate your own BMI on the Centers for Disease Control and Prevention website.

There are also requirements that must be met to qualify for surgery which may take up to 12 months to complete. These vary by location and include:

• Tobacco free 3-6 months
• Weight Management classes (may include individual assessment with dietitian and physical therapy)
• Mental Health evaluation
• Health Screenings (pre-operative risk evaluation, cancer screening, etc.)
• Medical Tests (vary by patient and may include endoscopy, pulmonary function test, sleep study, etc.)

Talk with your provider about your health concerns and goals to see what will be right for you.

Where can I get surgery?

If you are eligible for VA beneficiary travel, you will have the choice to be referred to VA Palo Alto in California. A VA Community Care option may also be available. Each location will have specific criteria that must be met for a Veteran to qualify.

What type of surgery can I get?

Surgery options may vary by location. If you qualify for surgery, the medical staff at the location for your surgery will explain the procedures available.

Learn more about and compare different metabolic/bariatric procedures.

The amount of weight loss after surgery depends on a Veterans overall commitment to change old habits, lifestyle, exercise and nutrition. After one year, Veterans may lose on average of 15-30% of their body weight depending on the type of surgery. Weight re-gain of 5-10% has been reported 10 years after surgery.