Yale, VA Researchers Develop New Health Metric for Veterans

Researchers at Yale School of Medicine and the U.S. Department of Veterans Affairs have developed an alternative method to measure quality of life in veterans who seek weight management, eating disorder, and nutrition services.

The health metric is called the “Weight and Eating Quality of Life (WE-QOL) Scale,” and the researchers say it can help determine how one’s weight and eating affects quality of life in critical areas.

The system was developed in response to emerging research which shows that being weighed at medical appointments unintentionally leads to weight gain. The WE-QOL is intended to assess traditional quality of life domains such as self-care and activities of daily living, physical discomfort or pain, and emotional and interpersonal distress.

To obtain a more nuanced quality of life assessment for weight and eating the research team added critical appearance-related areas to the new measure. This included difficulties such as feeling self-conscious, fearing ridicule about one’s weight or appearance, and experiencing distress about being in public (for example, fear of not fitting into seats) that interfere with quality of life.

Moderate to severe impacts were found for a large subset of veterans in all these areas including both the traditional and appearance-related critical areas, according to the study, which was published in the Journal of General Internal Medicine. The WE-QOL Scale outperformed a widely used generic measure of quality of life and simultaneously allowed for a more nuanced assessment of appearance-related difficulties.

“This new measure has potential to be used across VA programs targeting weight and obesity-related diseases while also improving veteran care,” said Robin M Masheb, PhD, professor of psychiatry and director of the Veterans Initiative for Eating and Weight at the VA Connecticut Healthcare System in West Haven. Masheb is the paper’s first author. Christopher B. Ruser, MD, associate professor of medicine at the Yale School of Medicine, and Eugenia Buta, PhD, research scientist in biostatistics at the Yale School of Public Health, are co-authors.

The Veterans Health Administration (VHA) is the largest healthcare system in the U.S., and it is a challenge to address obesity-related diseases in large numbers of veterans, Masheb said.

Determining a person’s body mass index is a useful tool to identify risks for obesity-related diseases, however research shows that weigh-ins at medical appointments are significant sources of weight stigma and paradoxically contribute to obesity.

Researchers in the WE-QOL study said it was for that reason they worked to develop the new scale, which they say has potential to standardize screening, referral, and evaluation across the range of VHA weight- and eating-related health services.

It also has the potential to be used as a “pre-post” tool to determine if after treatment and intervention, quality of life improves, thus improving patient care and quality of care.

Masheb said the researchers hope the new measure will improve eating- and weight-related patient care and quality of care for veterans and other healthcare system populations.

Publication: Robin M. Masheb PhD, et al., Development and Psychometric Assessment of the Weight and Eating Quality of Life (WE-QOL) Scale in US Military Veterans, Journal of General Internal Medicine (2023) DOI: 10.1007/s11606-023-08132-4

Original Story Source: Yale University