Any weight loss encounter – Clinic stop codes = 123, 124 (Nutrition/dietetics) or 372, 373 (MOVE!)

Number of weight loss encounters – *Only among those with a weight loss encounter.* Count unique clinic stops from first weight loss encounter to 9/30/2015

PCL checklist score difference (range of scores for PCL is 17–85) First PCL and last PCL in exposure year must be at least 8 weeks apart. A significant PCL decrease is defined as ≥ 20 point decrease (yes or no)

First PCL severity Severe – 70–85 Moderate – 50–69

End of follow-up = a. Any weight loss encounter = first stop code date or last visit date if no encounter b. Number of weight loss encounters = 9/30/2015

Baseline sociodemographics: Age, Gender, Race, marital status, VA only insurance

Primary healthcare utilization - number of unique primary care clinic stops per total months in entire VA system. Total months is calculated from first visit date to any VA facility in FY08 to FY15 to the index date. Stop codes from first VA visit to index date: 170, 172, 301, 322, 323, 348, 350

Depression –Presence of a single inpatient code or ≥2 outpatient codes within a 12 month period. Measured prior to index date. (296.2x, 296.3x, 311)

Other anxiety – Presence of a single inpatient code or ≥2 outpatient codes within a 12 month period. Measured prior to index date. Composite of panic disorder, ocd, social phobia, gad, anxiety nos (300.00, 300.01, 300.02, 300.23, 300.3)

Substance abuse/dependence –Presence in record of at least a single code for any alcohol or drug/abuse dependence before index date. Composite of alcohol (303.9x, 305.0x), sedative (304.1x, 305.4x), cocaine (304.2x, 305.6x), cannabis (304.3x, 305.2x), amphetamine (304.4x, 305.7x), hallucinogens (304.5x, 305.3x), ‘other’ (304.6x, 305.9x), opioid (304.0x, 305.5x), opioid with other SUD (304.7x), other SUD excluding opioid (304.8x), unspecified drug abuse/dependence (304.9x).

Smoking/nicotine dependence – Any smoking = “current smoker” in health factors or ICD9 code for nicotine dependence (V15.82, 305.1) before index date.

Adequate ADM treatment – any continuous period of ≥12 weeks ADM fills prior to index date. ADMs are: selective serotonin re-uptake inhibitors (SSRIs: citalopram, escitalopram, fluvoxamine, fluoxetine, paroxetine, sertraline, and vilazodone); serotonin and norepinephrine reuptake inhibitors (SNRIs: venlafaxine, duloxetine, milnacipran, and desvenlafaxine); tricyclic antidepressants (TCAs: amitriptyline, desipramine, doxepine, imipramine, nortriptyline, trimipramine, clomipramine, maprotiline, protriptyline, amoxapine); non-classified antidepressants (bupropion, nefazodone, trazodone, and mirtazapine); and monamine oxidase inhibitors (MAOIs: selegiline, phenelzine, tranylcypromine, and isocarboxazid).

PTSD Psychotherapy = from the first PCL date to index date. Clinic stop codes include 516, 540, 541, 561, 562 at ‘gold standard clinics’ (STA6A=534, 539, 662, 664, 664BY). Classified as adequate treatment (in any 15 week period, had 9+ visits) – yes vs. no

Baseline BMI = last BMI in the year prior to index date. Classified as: Overweight (25 to < 30), Class 1 Obese (30 to < 35), Class 2 Obese (35 to < 40), Class 3 Obese (≥ 40)

# of obesity-related comorbidities – Sum total of number of comorbidities out of 10 up to index date, classified as 0 vs. 1 vs. ≥ 2

Obesity-related comorbidities – Occur anytime up to index date Diabetes (250.x, 357.2, 362.0x, 366.41) – 134 (13.5%) Hypertension (401.x, 402.x, 403.x, 404.x, 405.x) – 459 (46.2%) Hyperlipidemia (272.x) – 455 (45.8%) Coronary/Ischemic Heart Disease (429.0, 429.1, 429.2, 429.9, 410.x, 411.x, 412.x, 413.x, 414.x, 440.x) – 114 (11.5%) Congestive Heart Failure (402.x, 404.0x, 414.19, 425.4, 428.x, 429.1, 429.4, 997.1) – 30 (3.0%) Cholelithiasis (574.x) – 8 (0.8%) Osteoarthritis (715.x) – 234 (23.6%) Low Back Pain (722.x, 724.x, 846.x, 847.x) – 626 (63.0%) Gastroesophageal Reflux (530.11, 530.81, 530.2x787.1) – 284 (28.6%) Obstructive Sleep Apnea (780.57, 786.03, 327.20, 327.21, 327.23, 327.29) – 283 (28.5%)

History of Gastric bypass – Any occurrence from FY2008-FY2015 ICD9 = V45.86, V53.51 ICD9 procedure = 44.31, 44.38, 44.39, 44.68, 44.95, 44.96, 44.97, 44.98 CPT = 43770 to 43775, 43644, 43645, 43842, 43843, 43845, 43846, 43847, 43848, 43850, 43855, 43860, 43865, 43886, 43887, 43888