Factors Influencing Weight Loss in Young and Middle-Aged Chinese Patients With Type 2 Diabetes and Overweight/Obesity: A Prospective Cohort Study.

BACKGROUND

The prevalence of young and middle-aged patients with Type 2 diabetes mellitus (T2DM) and overweight/obesity is increasing in China, yet determinants of weight loss success in this population remain unclear.

AIMS: To evaluate weight loss outcomes and identify factors associated with weight loss among young and middle-aged patients with T2DM and overweight/obesity.

METHODS

In this prospective cohort study, 282 patients with T2DM and overweight/obesity were recruited between March and September 2024. Baseline demographic, anthropometric, and psychosocial data were collected before discharge. Body weight was reassessed 3 months after discharge, and percentage weight loss was calculated. Participants were categorized into success (≥ 5% weight loss) and failure (< 5% weight loss) groups. Factors associated with weight loss were identified using univariate analysis, random forest importance ranking, LASSO regression, and multivariable logistic regression.

RESULTS

Using ≥ 5% weight loss as the clinical target, the overall success rate was 43.7%, with gender-specific rates of 39.5% in males and 58.0% in females. Random forest and LASSO analyses identified six key predictors: diabetes duration, extraversion, agreeableness, conscientiousness, diabetes self-efficacy, and social support. Multivariable logistic regression showed that diabetes duration (OR = 6.511, 95% CI: 1.92-22.05), extraversion (OR = 0.847, 95% CI: 0.73-0.98), agreeableness (OR = 1.228, 95% CI: 1.05-1.43), conscientiousness (OR = 1.254, 95% CI: 1.09-1.44), and diabetes self-efficacy (OR = 1.062, 95% CI: 0.993-1.14) were significant predictors of weight loss success.

CONCLUSIONS

Weight loss outcomes among young and middle-aged patients with T2DM and overweight/obesity were suboptimal and differed by gender. Diabetes duration, personality traits, and diabetes self-efficacy were independent predictors of weight loss success.