Association of overweight and obesity with health status, weight management, and exercise behaviors among individuals with type 2 diabetes mellitus or with cardiometabolic risk factors

James R Gavin, III¹, Helena W Rodbard², Kathleen M Fox³, Susan Grandy⁴ for the SHIELD Study Group

¹Emory University School of Medicine, Atlanta, GA, USA; ²Endocrine and Metabolic Consultants, Rockville, MD, USA; ³Strategic Healthcare Solutions, LLC, Monkton, MD, USA; ⁴AstraZeneca LP, Wilmington, DE, USA

Objectives: This investigation evaluated the role of obesity in health status and behaviors for weight management and exercise among individuals with type 2 diabetes mellitus (T2DM) or cardiometabolic risk factors.

Methods: Self-reported health status, exercise behaviors, and weight management were assessed in the SHIELD study for respondents with T2DM or high risk (HR) for diabetes (ie, ≥3 of the following: abdominal obesity, body mass index [BMI] ≥28 kg/m², self-reported diagnosis of dyslipidemia, hypertension, or history of cardiovascular disease). Respondents were stratified into three BMI categories: <25 kg/m² (underweight or normal weight), 25.0−29.9 kg/m² (overweight), and ≥30 kg/m² (obese), with comparisons made using analysis of variance. Comparisons between T2DM and HR were made using chi-square tests.

Results: T2DM (n = 3,918) and HR (n = 5,464) groups were similar for age (mean = 59 years), race (≥85% white), and obesity. Overweight (31%) or obese T2DM (18%) respondents were significantly less likely to report excellent health compared with overweight or obese HR respondents (42% and 30%, respectively), p < 0.001. There were no differences between T2DM and HR groups for exercise behaviors. More obese respondents (20% T2DM, 21% HR) were “contemplating exercising”, and fewer (21%−23%) were currently “exercising regularly” compared with overweight and normal weight respondents, p < 0.001. More obese respondents (78% T2DM, 83% HR) attempted weight management than normal (28%−35%) or overweight (57%−61%) respondents, p < 0.001.

Conclusions: Obesity was negatively associated with self-perception of current health, exercising regularly, and weight maintenance for those with or at risk for diabetes.

Keywords: overweight, obesity, type 2 diabetes mellitus, exercise, weight management