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PowerVet study explores weight loss and maintenance among older adults

Daniel Shimp
Pictured Above: Jimmie Witherspoon, Army Veteran

Daniel Shimp, 63, a Navy Veteran, knew he needed to lose weight. Struggling with some health issues related to injuries sustained during his 7.5-year Navy career and missing a calf on one leg, he needed a knee replacement, but his weight prohibited the procedure.

Now, thanks to a research study at the VA Maryland Health Care System which promotes successful weight loss in Veterans, he has shed 30 pounds and is on target to reach his goal.

Similarly, Jimmie Witherspoon, 68, who spent 15 years in the Army, is on a roll in reaching his goal weight of 220 pounds. After being discharged, his penchant for the wrong kind of snacks helped him reach his personal high, approximately 308 pounds. The surprising number and a diabetes diagnosis gave him a much-needed wake-up call. Although he successfully began his own self-directed weight loss program and shed more than two dozen pounds, he knew he needed more help and joined the same study, losing 50 more pounds.

The obesity epidemic, not unique to middle-aged adults or children, is prevalent among older adults and continues to rise. Although obesity rates tend to be higher among non-Veterans, more than 70 percent of Veterans who receive care at VA are overweight or obese.. Being overweight or obese can have a dire impact on older adults, effecting quality of life and leading to chronic conditions such as diabetes, high blood pressure, high cholesterol and cardiovascular disease, reducing mobility, causing a loss of independence, and thereby increasing the risk of institutionalization. Known as the PowerVet study, the randomized study explores the question of whether an intense 12-week weight management intervention including weight loss and exercise can assist overweight Veterans, and then if their experience and education achieved during the 12-week intervention can help them maintain the weight loss on their own. After the weight loss phase of the study, Veterans are followed for 24 weeks during the second phase, or weight maintenance phase, where they are randomized to an intermittent fasting weight maintenance group or weight maintenance control group.

Shimp and Witherspoon are among the more than 200 participants of a multi-site clinical trial at the Baltimore and San Antonio VA Medical Centers. The main goal of the study is to learn if intermittent fasting—not time restricted but calorie restricted—could have an impact on weight loss and on preventing weight regain, which is common after weight loss. Dr. Alice Ryan, the principal investigator at the study’s Baltimore site, says it also seeks to examine if certain enzymes play an important role in weight maintenance and regain.

“Participants are followed through the entire study and to be accepted into the study, undergo a series of tests,” said Ryan. “We hope to find out if the intermittent fasting will provide the stimulus for the prevention of weight regain during six months and will improve functional and metabolic health outcomes.”

During the intensive intervention segment, participants are given tools such as a scale, a Fitbit, exercise bands, and a weekly cooler of food. They meet with the study’s dietitian, Kelly Ort, R.D., who works to ensure that the reduced calorie menu is individualized as needed for each participant. “The menus follow healthy plate and heart healthy diet guidelines and are modified for each participant’s food allergies, intolerances and preferences,” Ort says, also noting that she works to ensure that the food provided is appealing and satisfying to the participants. “Veterans recently asked to add beans to the menu, so we added dried beans and explain the best way to cook them.”

“They’ve been really good about changing things out if I told them I didn’t like something,” says Witherspoon, who now has reached the second phase of the study.

During the weight loss phase of the study, participants are also required to exercise twice a week at the Baltimore VA Annex and to exercise a third day at home on their own both walking and using the exercise bands.

“The quality of the food is great. At first it was hard getting used to the portion sizes. Getting the food makes is easier to stick to the diet,” said Shimp, currently in the study’s second phase.

Meeting with the dietitian and exercise physiologists may represent the Veterans’ first exposure to healthy eating, portion control, and other elements of healthy living. “We hope the knowledge they gain during the weight loss phase will help them maintain their weight in the second phase,” said Ryan.

Both Shimp and Witherspoon remain on track to reach their goals, Shimp still in the intervention segment and Witherspoon in the weight maintenance segment. “I now exercise regularly with my daughter,” said Witherspoon who continues with the exercise regimen and makes a conscious effort to eat healthy.

Veterans who want to participate in the study can call the study coordinator Mason Cervantes at 443-422-7234.

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