The value and impact of weight reduction from the perspective of people with type 2 diabetes in the United States

Abstract

Aims: To understand the importance and potential impacts of reaching a lower weight or body mass index (BMI) from the perspectives of people with type 2 diabetes (T2D) across BMI levels.

Materials and methods: A cross-sectional survey, informed by qualitative interviews, was administered to a sample representative of the US T2D population by BMI. The survey asked about experience and perceptions of weight management, the impact of T2D on quality of life (QoL), and the value of 5%, 10%, and 20% weight reductions. Results were summarised descriptively.

Results: Among 388 participants (54% male; 10% Hispanic; 90% White; mean age 61 years [SD: 13]; mean self-reported BMI 32.7 kg/m² [SD: 8.4]), 47% had a current haemoglobin A1c <7%. T2D affected QoL with impacts on comorbidities (39%), health complications (29%), emotional well-being (29%), and daily activities (28%). Most reported that the impact of weight on T2D was an issue (89%), they needed to lose weight (87%), and they struggled to lose weight (76%). Nearly all felt weight management was important to managing their T2D (93%), and 5%/10%/20% weight reductions would positively impact their perception of their future with T2D (60%/74%/69%, respectively). The majority felt 5%/10%/20% weight reductions would have positive impacts (72%/79%/70%, respectively), specifically on their appearance (70%/81%/83%, respectively), comorbidities (59%/72%/80%, respectively), and emotional well-being (51%/58%/66%, respectively).

Conclusions: People with T2D, across BMI categories, place considerable value on the opportunity for weight reduction yet endure considerable challenges in doing so through lifestyle interventions, even when weight reduction is discussed with their healthcare provider.

Keywords: barriers; patient‐reported outcomes; type 2 diabetes; weight control; weight management.

FIGURE 1

(A) Impact of T2D on QoL (n = 388).^a (B) Impact of weight on T2D (n = 388).^b Data from Phase II, online survey. Questions asked as: ^a“How has having diabetes impacted your quality of life?” ^b“How, if at all, has your weight impacted your diabetes?” Response options were not mutually exclusive. Abbreviations: QoL, quality of life; T2D, type 2 diabetes.

FIGURE 2

Average percentage weight reduction needed to reach achievable, dream, acceptable, and unsuccessful weight (n = 388). Data from Phase II, online survey. Desired weight reduction in percentage was calculated as (Actual Weight − Inputted Weight)/Actual Weight × 100. Questions asked as: “What is your goal weight, the weight you realistically expect to achieve and maintain?/What is your dream weight, the weight you would reach and maintain if you could weigh whatever you want?/What weight could you accept if you achieved and maintained this weight?/What weight would you not view as successful if you achieved and maintained that weight?” Abbreviations: SD, standard deviation.

FIGURE 3

Impact of 5%, 10%, and 20% body weight reductions (n = 388). Data from Phase II, online survey. Questions asked as: ^a“How meaningful would it be for you to lose [5%/10%/20% of body weight from screener] lbs (5%/10%/20% of your body weight)?” ^b“To what extent would your life be impacted if you lost [5%/10%/20% of body weight from screener] lbs (5%/10%/20% of your body weight)?” ^c“If you lost [5%/10%/20% of body weight from screener] lbs (5%/10%/20% of your body weight) with a medication in approximately one year, to what extent would it change your perceptions of your future with diabetes?” Abbreviations: T2D, type 2 diabetes.