Determinants of Clinically Significant Weight Loss Among People with Obesity: The Roles of Healthcare Engagement, Motivation, and Comorbidities

Background: A 5–10% weight loss has shown significant clinical improvements in the overall well-being of people with obesity (PwO). This study investigated the characteristics of PwO, their interaction with healthcare providers (HCP), associated comorbid conditions, and how these factors influence greater weight loss. Methods: A cross-sectional analysis of PwO aged ≥ 18 years using data from the Saudi Arabia Awareness, Care and Treatment in Obesity Management (ACTION-IO) study. We evaluated the relationship between PwO who achieved 5 to <10% weight loss (LWL) and those who achieved ≥10% weight loss (HWL) during the preceding 3 years. Owing to the cross-sectional design, associations rather than causal relationships were evaluated between participant characteristics and clinically significant weight loss. Results: A total of 842 PwO were surveyed, 133 (15.8%) had HWL, and 709 (84.2%) had a weight loss of <10% within 3 years (LWL). HWL was observed in individuals with cardiovascular disease and depression/anxiety, as well as those who were motivated and committed to weight-loss interventions. PwO who had LWL had fewer interactions with their HCP and had a lack of support from friends and family. After adjustment for demographic factors, exercise, and weight-loss medication use, having discussed weight management with a healthcare provider within the previous 6 months (OR = 2.525, 95% CI = 1.692–3.768, p < 0.001), commitment to weight-loss action (OR = 1.572, 95% CI = 1.071–2.309, p = 0.021), cardiovascular disease (OR = 2.496, 95% CI = 1.175–5.300, p = 0.020), and depression/anxiety (OR = 2.734, 95% CI = 1.605–4.655, p < 0.001) were independently associated with achieving ≥10% weight loss. Conclusion: Greater weight loss was associated with more frequent discussions with healthcare providers, higher motivation and commitment to weight-loss efforts, and stronger family support. Cardiovascular disease and depression/anxiety were also independently associated with clinically significant weight loss. These findings identify factors associated with successful weight loss that warrant further investigation in longitudinal studies.