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Weight management program at the Minneapolis VA Medical Center
The weight management services of the Minnesota Obesity Center at the Minneapolis VA Medical Center are aimed primarily at veterans with severe obesity (BMI >35 and/or weight > 300 pounds) and include a variety of approaches. The most intensive nonsurgical program begins with a two-week inpatient stay on the Special Diagnostic and Treatment Unit. This two-week session is intended to provide the patient, some of whom live a distance away, with the tools to begin weight management. The education program is geared to a " learning by doing" approach to changing food and activity choices, and is taught by nurses, dietitians and exercise therapists. The initial calorie level of the diet is 800 calories per day, but increases to 1200 calories per day in the second week. The exercise therapists work directly with the patient to find feasible means of exercising, even among those with physical impairments. Physicians are available to respond to changing medical needs and psychologists can be called upon to evaluate and counsel those with particular psychological needs.
The patients completing the inpatient program are sent on to the Mass Clinic for follow-up care. In addition, patients may enter the Mass Clinic program directly after evaluation by an intake team. The Mass Clinic offers a group as well as an individual approach to ongoing care, and patients do either or both approaches. The goals of this program are to reinforce the education about the potential for altering food and activity choices. Most importantly, the Mass Clinic is a problem solving session, where the struggles of individuals can be discussed and plans agreed upon for approaching those struggles. Some patients will be offered additional therapy with pharmaceuticals in this context and appropriate follow-up for that therapy will be carried out.
Other alternatives available through the Minneapolis VA Medical Center include a ten-week, outpatient program emphasizing Behavior Modification as the primary approach and a bariatric surgery program.
More information can be found at http://www.umn.edu/mnoc
Charles J. Billington, M.D.
Charles J. Billington, M.D. is Associate Director of the Minnesota Obesity Center, a statewide resource for obesity research, clinical approaches and education supported by the national institutes of Health and the University of Minnesota. He is Director of the Special Diagnostic and Treatment Unit and Medical Director of the Medical Subspecialty Clinics at the Minneapolis VA Medical Center and Professor of Medicine at the University of Minnesota. The obesity treatment program at the Minneapolis VA Medical Center was created and is directed by Dr. Billington.
Dr. Billington received his undergraduate degree from Rice University in 1975 and his Medical degree from the University of Kansas in 1978. He is Board Certified in Internal Medicine and Endocrinology and Metabolism. He has been on the staff of the Minneapolis VA Medical Center and the University of Minnesota since 1983. Dr. Billington is active in the North American Association for the Study of Obesity, where he has served as Chairman of the Education Committee, is currently Vice President, and will serve as President in 2000-2001. He has served on the Nutrition Study Section of the National Institutes of Health and is currently a member of the NIH National Task Force on the Prevention and Treatment of Obesity.
Dr. Billington's interest in obesity grew out of two sources. The first was a recognition that many of the diabetes problems he was seeing in his clinical endocrinology practice were related to obesity and were potentially treatable by a weight loss. The second was his research into the hormonal and brain mechanisms that regulate appetite and metabolism. It is hoped that progress in understanding basic mechanisms can be applied to the clinical problems of obesity and diabetes. Grant awards from the Department of Veterans Affairs and the National Institutes of Health support these research programs. Reports related to this research and related clinical activities have resulted in more than 100 articles and book chapters.
