TOPLINE:

User engagement in a digital weight-loss service enhanced the effectiveness of GLP-1 receptor agonists and the dual glucose-dependent insulinotropic polypeptide (GIP)-GLP-1 receptor agonists in adults with overweight or obesity, resulting in greater weight loss and increased likelihood of achieving milestones than nonengagement.

METHODOLOGY:

• Researchers conducted a retrospective study to analyze the impact that engagement in a digital weight-loss service (DWLS) might have on weight-loss outcomes among the app’s users with BMI ≥ 27 and at least one obesity-related comorbidity or BMI ≥ 30.
• The cohort consisted of 106,653 adults (mean age, 42.3 years; 77.9% women; mean baseline BMI, 35.2) who were prescribed dual GIP/GLP–1 receptor agonist (tirzepatide) or GLP-1 receptor agonist (semaglutide) via the Voy DWLS.
• Researchers used clinical data, including body weight, height, BMI, and baseline self-reported comorbidities such as polycystic ovarian syndrome, high cholesterol, hypertension, and diabetes, gathered from the app.
• Digital engagement was defined as attendance at one or more personalized lifestyle coaching sessions delivered remotely, weight tracking at least four times per month, and at least one additional app interaction. Among participants, 6086 (5.7%) met the digital engagement criteria and 100,567 (94.3%) did not.
• The primary outcome was percentage weight change from baseline at each month of follow-up modeled over 11 months and adjusted for baseline age, sex, BMI, and comorbidities. Secondary outcomes were achievement of clinically significant weight-loss thresholds (≥ 5%, ≥ 10%, ≥ 15%, ≥ 20%, and ≥ 25% of total body weight) and time to achievement of those thresholds.

TAKEAWAY:

• Engaged participants lost a greater mean percentage of weight each month, ending at -21.5% vs -17% at 11 months (P < .001 for all).
• Digital engagement was associated with greater odds of achieving weight-loss milestones than nonengagement, with hazard ratios of 1.42 for ≥ 5% of body weight lost, 1.46 for ≥ 10% lost, 1.53 for ≥ 15% lost, 1.62 for ≥ 20% lost, and 1.86 for ≥ 25% lost by month 11 (P < .001 for all).
• Weight regain analysis revealed a lower rate of regain to baseline weight in the engaged group compared with the nonengaged group (1.1% vs 3.1%).
• Safety analysis showed no significant difference between engagement and nonengagement groups.

IN PRACTICE:

“We demonstrate that digital engagement confers substantial and clinically meaningful enhancement of WL[weight loss],” the authors wrote.

SOURCE:

This study, led by Hans Johnson, MBChB, Department of Digital Health and Care, University of Bristol, Bristol, England, was published online in Diabetes, Obesity and Metabolism.

LIMITATIONS:

The retrospective design and nonrandomized allocation introduced the risk for selection bias and confounding. Self-reported weight measurements introduced human error and reporting bias. Despite adjusting for baseline demographics and clinical variables, residual unmeasured confounding from socioeconomic factors, health literacy, digital competency, or intrinsic motivation remains possible.

DISCLOSURES:

No external funding was received for this study. The research was conducted as part of routine service evaluation activities within Voy. The authors disclosed serving as clinical researcher, head of clinical research, innovation director, and research advisor for Voy, part of Menwell Ltd.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.