Weight loss intention, dietary behaviors, and barriers to dietary change in veterans with lower extremity amputations

A.J. Littman, Ph.D., L.V. McFarland, Ph.D., M.L. Thompson, Ph.D., E.D. Bouldin, M.P.H.,D.E. Arterburn, M.D., B.R. Majerczyk, M.P.H., E.J. Boyko, M.D.

Disability and Health Journal, Volume 8, Issue 3, Pages 325–335
Published Online: November 29, 2014


Obesity is thought to be highly prevalent in persons with lower extremity amputations (LEAs) and can impair physical and social functioning.


The aim of this study was to determine the prevalence of weight loss intention, weight loss strategies, dietary patterns, and barriers to making dietary changes, and their associations with body mass index (BMI, kg/m2), amputation characteristics, health status, and socioeconomic factors.


We conducted a cross-sectional study (n = 150) using data from a self-administered questionnaire.


43% of participants were obese and 48% were trying to lose weight; 83% of those trying to lose weight reported trying to “eat differently”, but only 7% were following a comprehensive weight loss program involving dietary changes, physical activity, and behavioral counseling. 21% of participants reported ≥6 barriers to changing their eating habits (e.g., habit, too little money, stress/depression). Obesity was associated with younger age, lower physical health scores, hypertension, arthritis, and diabetes. Compared to those not trying to lose weight, a greater proportion of those trying to lose weight had a BMI ≥35 kg/m2, age <55 years, higher physical and mental health scores, and more frequent consumption of vegetables, beans, chicken, and fish.


Though over half of overweight and obese individuals with LEA were trying to lose weight, few reported following a comprehensive program to lose weight, which may indicate an unmet need for services for this group. To be effective, these programs will need to address the complex physical and mental health challenges that many of these individuals face.