Identifying a window of opportunity when patients are motivated to lose weight might improve the effectiveness of weight loss counseling. The onset of chronic disease could create such a window.
To determine whether identifying prediabetes was associated with subsequent weight loss.
Our retrospective cohort study included adults with obesity and a primary care visit between 2015 and 2017. Data were collected and analysed in 2019/2020. We compared patients who developed prediabetes [haemoglobin A1c (HbA1c) ≥5.7 and <6.5] to patients with a normal HbA1c (<5.7). We ran linear regression models to identify the association between identifying prediabetes and percent body mass index (BMI) change at 6 and 12 months. The adjusted model controlled for demographic characteristics at baseline, Charlson comorbidity score, and metformin, antipsychotic, antidepressant and antiobesity medication prescribed in either the first 3 months (for the 6-month outcome) or first 9 months (for 12-month outcome) and clustering within physician.
Of 11 290 participants, 43% developed prediabetes. At 6 months, 15% of the prediabetes group lost ≥5% of their BMI compared with 13% of the comparison group. The results were similar at 12 months with 18% of the prediabetes group losing ≥5% of their BMI compared with 17%. The prediabetes group lost a higher percentage of their BMI (β = -0.7% versus -0.3% at 6 months and β = -0.5% versus 0.01% at 12 months).
While the percent of BMI change was small, patients with newly identified prediabetes lost more weight than a comparison group.

© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: