Presentation (CTI)

OBJECTIVES: To analyze trends in weight loss activities among adults with prediabetes and obesity in the United States from 2009 to 2020 and identify disparities in engagement based on demographic and socioeconomic factors.
METHODS: Using data from the National Health and Nutrition Examination Survey (NHANES) from 2009-2020, the study included adults aged ≥20 years with prediabetes (HbA1C: 5.7-6.4%, FBG: 100-125 mg/dL, or OGTT: 140-199 mg/dL) and obesity (BMI ≥30 kg/m² or ≥27.5 kg/m² for Asians). Exclusion criteria included diagnosed diabetes or missing relevant data. Weight loss activities included dietary modifications, physical activity, prescription/non-prescription medications, or other interventions. Descriptive statistics, chi-square tests, and logistic regression models assessed trends and predictors across survey waves.
RESULTS: Of the 1,180 participants, 87.8% engaged in at least one weight loss activity. Physical activity (69.1%) and dietary modifications (64.9%) were the most common. Engagement remained stable, increasing slightly from 83.9% (2009-2010) to 90.1% (2017-2020). Younger adults, individuals with higher incomes, greater education levels, and health insurance were more likely to engage in weight loss activities. Conversely, older adults, lower-income individuals, and uninsured participants exhibited lower engagement. The underutilization of weight loss medications (5.8%) contrasted with clinical guidelines, emphasizing reliance on lifestyle interventions.
CONCLUSIONS: Weight loss activities are prevalent among obese adults with prediabetes in the U.S., with significant demographic and socioeconomic disparities. These findings underscore the need for tailored interventions to address barriers in disadvantaged populations and suggest future studies explore the impact of pharmacotherapies, such as GLP-1 receptor agonists.