This study involves an evaluation of whether social support from a cohabitating adult improves Veteran weight loss in a weight management program.

Dyads comprising a Veteran with obesity and a cohabitating adult will be randomized to participate in a weight management program by the Veteran alone or with their support person. The program will be delivered by research staff using a secure video platform. Outcomes will be assessed remotely at baseline and weeks 24, 48, and 72, with 72 weeks as the primary endpoint.

Inclusion Criteria:

Patient inclusion criteria

• aged 18 years or older
• BMI >= 30 kg/m2
• at least one visit with a VA primary care provider within the past year
• weight <=420 lb due to study scale limits
• have been cohabitating and have daily contact over the past 6 months with an adult who can provide support (e.g., spouse/domestic partner, sibling, adult child, friend, family member) for the next 18 months
• desire to lose weight
• able to stand for weight measurements without assistance
• < 2 errors on a validated 6-item cognitive screener
• ability to speak English
• agrees to attend visits per protocol
• individual email-address
• access to hardware and internet connection to enable participation with approved virtual platform Partner inclusion criteria
• aged 18 years or older
• willing to participate
• < 2 errors on a validated 6-item cognitive screener
• ability to speak English
• individual email address

Exclusion Criteria:

Patient exclusion criteria

• active dementia or substance abuse
• history of bariatric surgery or planning to have bariatric surgery in the next 18 months
• pregnancy or planning to become pregnant in the next 18 months, or breastfeeding
• weight loss >= 10 lb in the month prior to screening
• living in a facility such as a nursing home, skilled nursing facility, or assisted living facility
• unable to control what food is purchased and / or served
• impaired hearing
• current use of weight loss medications
• chronic or unstable illness that would limit ability to participate (e.g., recent hospitalization)
• participation in VA MOVE! weight management program in the past 6 months
• current participation in a research or clinical program focusing on lifestyle change
• vomits once or more per week Partner exclusion criteria
• BMI < 18.5 kg/m2
• active dementia or substance abuse
• impaired hearing
• chronic or unstable illness that would impair their ability to provide support
• living in a facility such as a nursing home, skilled nursing facility, or assisted living facility