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Obesity is a tremendous public health problem that increases the risk of several types of cancer. Weight loss treatments to date have not led to lasting individual or population improvements in body weight. There is growing recognition that the environment, such as access to healthy foods and places to exercise, affects our ability to eat healthfully and engage in physical activity. Thus, to solve the obesity problem, we need to identify population-based strategies such as public policy and environmental change, as well as more effective weight loss treatments.

Scarce longitudinal and nationwide evidence on environment-obesity associations hampers our ability to identify the most promising targets of public policy and environmental change. Moreover, little is known about how the environment affects individuals’ ability to succeed when trying to lose weight. Or whether weight loss treatments can be more effective if “matched” to individuals’ environments.

U.S. military veterans who use healthcare services from the U.S. Department of Veterans Affairs (VA) represent an important segment of the U.S. population that is disproportionately affected by obesity. Led by Drs. Elizabeth Tarlov and Shannon Zenk, the Weight and Veterans’ Environments Study (WAVES) I and II are complementary cohort studies of over 3 million U.S. military veterans who received VA healthcare between 2009 and 2015. We are studying multiple attributes of the environment where they live: access to food outlets (like supermarkets, mass merchandisers, grocery stores, convenience stores, fast food restaurants), food prices, access to recreational resources (like parks, fitness facilities), walkability (like street connectivity, proximity of destinations), safety, and sociodemographics.

Weight and Veterans’ Environments Study (WAVES) I

The goals of WAVES I are to identify attributes of the environment that help people to maintain healthier BMI and metabolic risk status (e.g., blood pressure, glucose, cholesterol) for up to 7 years, and also environmental attributes that help people participating in the VA MOVE! weight management program to lose weight at six months and maintain weight loss longer term. The focus is on people in metropolitan areas of the continental U.S.

This study is funded by the National Institutes of Health/National Cancer Institute (R01CA172726).

Weight and Veterans’ Environments Study (WAVES) II

The goal of WAVES II is to determine whether people are more likely to engage in the VA MOVE! program and lose weight when MOVE! program elements substitute for environmental limitations or complement environmental resources. We are examining nutritional, behavioral, physical activity, and distance support elements of the VA MOVE! program. We will also see whether these relationships differ by race/ethnicity, gender, and urbanicity. The focus is on those in metropolitan and non-metropolitan areas of the continental U.S.

This study is funded by the U.S. Department of Veterans Affairs Office of Research and Development (VA IIR 13-085).