Analysis of Weight Loss Attitudes and Behaviors of Metabolically Healthy and Unhealthy Adults in the United States, 2009-2014

BackgroundRecent evidence suggests that moderate diet-induced weight loss reduces cardiometabolic risk in individuals who are "metabolically unhealthy normal weight" (MUH-NW). However, while weight management in people with obesity is well-studied, the relevant attitudes and behaviors in lean people are unknown. The lack of information about weight loss perceptions in the MUH-NW prompted an investigation into the factors that influence weight management practices in metabolically healthy and unhealthy American adults.MethodsPopulation-based cross-sectional analysis of American adults (n=6,218; weighted n=195.7 million; age≥20) using pooled data from the 2009-2014 National Health and Nutrition Examination Surveys. The explanatory variables of interest were metabolic health, perceived weight status, and measured weight status. The outcomes of interest were weight perception, weight loss intent and successful weight loss. Logistic regression models were adjusted for known confounders including age, race/ethnicity, sex, and income-to-poverty ratio. ResultsIn adjusted models, adults who were metabolically unhealthy had 1.404 (1.167-1.689) the odds of intending to lose weight and 1.043 (0.876-1.242) the odds of successfully losing weight compared with metabolically healthy adults. Adults who perceived themselves as overweight had 6.124 (5.229- 7.172) the odds of intending to lose weight when compared to adults who perceived themselves as normal weight, and adults who measured as overweight had 3.920 (3.173-4.843) the odds of intending to lose weight when compared to adults who measured as normal weight. ConclusionsMetabolic health can influence individuals’ weight management behaviors. Weight perceptions may play a greater role than measured weight in shaping weight loss intention.Bachelor of Science in Public Healt