The Burden of Obesity Among a National Probability Sample of Veterans


  • Karin M. Nelson MD, MSHS

    1. Primary and Specialty Medical Care Service, VA Puget Sound Health Care System, Seattle, WA, USA
    2. Department of Medicine, University of Washington, Seattle, WA, USA
    3. Health Services Research and Development, VA Puget Sound Health Care System, Seattle, WA, USA.
    Search for more papers by this author

  • The views expressed in this article are those of the author and do not necessarily represent the views of the Department of Veterans Affairs.

Address correspondence and requests for reprints to Dr. Nelson: 1660 South Columbian Way, S-111-GIMC, Seattle, WA 98108-1597 (e-mail:


BACKGROUND: Few national data exist about the prevalence of obesity and the resulting health burden among veterans.

METHODS: We analyzed data from the 2003 Behavioral Risk Factor Surveillance System (n=242,362) to compare rates of obesity among veterans who do and do not utilize the VA, compared with nonveterans. We used bivariate analyses to describe the association of obesity with lifestyle factors, disability, and comorbid disease, and multivariate analysis to assess the independent association of obesity with VA care.

RESULTS: Veterans who use the VA for health care have the highest rates of obesity compared with veterans who do not use the VA and nonveterans (27.7% vs 23.9% vs 22.8%, P<.001). Only 27.8% of veterans who receive health care at the VA are of normal weight (vs 42.6% of the general population, P<.001), 44.5% are overweight, 19.9% have class I obesity, 6% have class II obesity, and 1.8% are morbidly obese (an estimated 82,950 individuals). Obese veterans who utilize the VA for services have higher rates of hypertension (65.8%) and diabetes (31.3%), are less likely to follow diet and exercise guidelines, and more likely to report poor health and disability than their normal-weight counterparts.

CONCLUSIONS: Veterans who receive care at the VA have higher rates of overweight and obesity than the general population. At present, less than half of VA medical centers have weight management programs. As the largest integrated U.S. health system, the VA has a unique opportunity to respond to the epidemic of obesity.