3085-LB: National Trends in Weight-Loss Attempts, Weight-Loss Strategies, and Clinically Meaningful Weight Loss among U.S. Adults with Diabetes and Overweight or Obesity, 1999–2023: A Serial Cross-Sectional NHANES Analysis

Introduction and Objective: Weight management is central to diabetes care, yet little is known about how often people with diabetes attempt weight loss, which strategies they use, and whether these efforts lead to clinically meaningful weight loss. We examined national trends in weight-loss attempts, strategies, and successful weight loss among U.S. adults with diabetes and overweight or obesity. Methods: We conducted cross-sectional analyses of NHANES 1999-2000 through 2021-2023. Adults aged ≥20 years with diabetes and BMI ≥25 kg/m² were included (N=7,771). Outcomes were self-reported attempt to lose weight in the prior year and achieving ≥5% or ≥10% weight loss among attempters. Weight-loss strategies were assessed among attempters. Survey-weighted prevalence was estimated, and trends were tested using logistic regression. Results: Participants had mean age 58.5 years; 52.4% were male; and 68.2% had obesity. Overall, 61.1% reported attempting weight loss, with no significant trend over time (P-trend=0.584). Among attempters (n=4,396), 37.8% achieved ≥5% weight loss and 17.6% achieved ≥10%, with no improvement over time (P-trend=0.901 and 0.570, respectively). Attempts were more common among participants with obesity than overweight (70.0% vs 41.8%). Common strategies included eating less food (68.0%), exercising (48.3%), drinking more water (39.7%), choosing low-calorie foods (36.1%), and eating less fat (36.0%). “Changed eating habits” and weight loss surgery was associated with higher odds of weight loss, whereas diet products and special diets were associated with lower odds of success. Conclusion: Among U.S. adults with diabetes and overweight or obesity, weight-loss attempts were common, but clinically meaningful weight loss was achieved by a minority and did not improve over time. These findings highlight a persistent gap between weight-loss efforts and population-level success in diabetes care. Disclosure L. Liu: None. G. Xiong: None.