Engagement in a digital weight-loss service (DWLS) significantly improves the effectiveness of GLP-1 receptor agonists and dual GIP-GLP-1 receptor agonists, boosting weight loss and increasing the likelihood of achieving key weight-loss milestones among adults with overweight or obesity.
Study Overview
A retrospective study investigated the impact of user engagement in a DWLS on weight-loss outcomes for individuals with a body mass index (BMI) of 27 or higher and at least one obesity-related comorbidity, or a BMI of 30 or higher. The study included 106,653 adults (average age 42.3 years; 77.9% women; average BMI 35.2) who were prescribed GLP-1 (semaglutide) or dual GIP/GLP-1 receptor agonists (tirzepatide) through the Voy DWLS platform.
Researchers analyzed clinical data from the app, which included body weight, BMI, and self-reported comorbidities such as hypertension, high cholesterol, polycystic ovarian syndrome, and diabetes.
Digital Engagement Definition
Participants were considered digitally engaged if they attended at least one personalized lifestyle coaching session, tracked their weight at least four times per month, and interacted with the app in other ways. Of the participants, 5.7% met the engagement criteria, while 94.3% did not.
Key Findings
Engaged users lost a greater percentage of weight each month. By month 11, those who engaged with the app lost an average of 21.5% of their body weight, compared to 17% for non-engaged users (P < .001 for all comparisons).
Digital engagement was linked to higher chances of reaching significant weight-loss milestones, with hazard ratios for achieving various weight-loss thresholds as follows:
1.42 for ≥ 5% weight loss
1.46 for ≥ 10% weight loss
1.53 for ≥ 15% weight loss
1.62 for ≥ 20% weight loss
1.86 for ≥ 25% weight loss (P < .001 for all).
The engaged group showed a lower rate of weight regain, with only 1.1% of participants regaining baseline weight, compared to 3.1% in the non-engaged group.
Safety analysis revealed no significant difference in safety outcomes between the engaged and non-engaged groups.
Implications
The study underscores that active participation in digital weight-loss programs can significantly enhance weight-loss outcomes, making engagement a valuable component for improving the effectiveness of GLP-1 treatments.
Study Source
This research, led by Dr. Hans Johnson at the University of Bristol’s Department of Digital Health and Care, was published in Diabetes, Obesity and Metabolism.
Limitations
The study’s retrospective nature and non-randomized design introduce potential bias, including selection bias and confounding variables. Additionally, self-reported weight measurements may lead to reporting inaccuracies. Despite adjustments for baseline factors, unmeasured confounding such as socioeconomic status, health literacy, digital skills, and personal motivation cannot be ruled out.
Disclosures
The study received no external funding. It was part of routine service evaluation activities within Voy. The authors disclosed their roles as clinical researchers and advisors for Voy, a part of Menwell Ltd.
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