Factors Influencing Weight Loss in Young and Middle-Aged Chinese Patients With Type 2 Diabetes and...

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.

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

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.

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.

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.