ABSTRACT Background Obesity is a key contributor to type 2 diabetes, and weight loss is a central component of diabetes management. Although clinical guidelines recommend that healthcare providers offer weight management advice, its real‐world impact remains unclear. Objective This study assessed the associations of doctor‐advised and self‐initiated weight management with weight loss among individuals with type 2 diabetes who are overweight or obese. Methods Data were obtained from the National Health and Nutrition Examination Survey (NHANES 2011–2018). People with diabetes and overweight or obesity (body mass index ≥ 25 kg/m 2 ) were categorized into four groups according to doctor‐advised weight loss and weight management status. Outcomes included one‐year weight change, assessed both continuously (percentage change) and categorically (≥ 5% and ≥ 10% weight loss). Linear regression was used for continuous outcomes and Poisson regression with robust standard errors for categorical weight loss. Results Among 1715 individuals (61.1 ± 12.4 years, 49.1% female), 1020 received doctor‐advised weight loss, and 89.6% initiated weight management. However, individuals who received advice achieved less weight loss than those not advised, particularly among those who did not engage in weight management ( β : 5.07, 95% CI 3.07 to 7.07, p < 0.001). Individuals who received advice were also substantially less likely to achieve ≥ 5% (RR 0.15, 95% CI 0.06 to 0.39, p < 0.001) or ≥ 10% weight loss (RR 0.20, 95% CI 0.10 to 0.41, p < 0.001). Conclusions Only three out of five participants with diabetes and overweight or obesity were advised by healthcare providers to lose weight. While weight loss advice spurred individuals to engage in weight management, those who received weight loss advice encounter greater challenges in reaching weight loss targets.
Zhang et al. (Tue,) studied this question.
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