Comparison of obesity prevalence and associated factors among Thai patients with type 2 diabetes between 2014 and 2018

Obesity is an emerging public health issue and a significant risk factor for type 2 diabetes mellitus (T2DM). The growing prevalence of obesity in T2DM patients worsens disease outcomes, elevates medical expenses, and increases the risk of cardiovascular complications. Recognizing the trends and related factors of obesity in T2DM patients is essential for guiding specific interventions and public health strategies. This study aims to analyze the trends in obesity prevalence among T2DM patients in Thailand from 2014 to 2018 and to identify significant demographic, clinical, and lifestyle factors linked to obesity. This sequential cross-sectional study utilized secondary data from the Thailand DM/HT database in 2014 and 2018. It did not include individuals under 18 or those with incomplete data. Descriptive statistics were used to analyze demographic characteristics and obesity prevalence, while multivariable logistic regression was employed to identify factors independently associated with obesity. Additionally, linear regression analysis assessed the relationships between BMI and continuous variables, including age, systolic blood pressure (SBP), and HbA1c levels. A total of 32,196 patients in 2014 and 38,119 in 2018 were included. The prevalence of obesity among T2DM patients rose from 49.9% in 2014 to 51.1% in 2018, with obesity prevalence in males increasing from 48.5 to 51.0% (P < 0.001), whereas females exhibited a higher prevalence. Obesity was associated with younger adults (AOR 4.91, 95% CI 4.06–5.94) and those with hypertension (AOR 1.83, 95% CI 1.72–1.94). The risk of obesity showed an inverse correlation with a longer duration of diabetes (AOR 0.67, 95% CI 0.57–0.78). An inverse association was observed between smoking and obesity, with never-smokers having a greater risk of obesity compared to current smokers (AOR 1.69, 95% CI 1.48–1.92). Moreover, indoor occupations were associated with an increased rate of obesity (AOR 1.36, 95% CI 1.24–1.48). The prevalence of obesity among T2DM patients in Thailand has continued to rise, particularly among men and young people. These findings suggest that T2DM obesity requires targeted lifestyle changes, weight management programs, and policy initiatives. Strengthening public health strategies that promote physical activity, dietary improvements, and access to effective diabetes management resources is critical for reducing obesity-related complications.