@Article{info:doi/10.2196/69466,
author="Johnson, Hans
and Huang, David
and Liu, Vivian
and Ammouri, Mahmoud Al
and Jacobs, Christopher
and El-Osta, Austen",
title="Impact of Digital Engagement on Weight Loss Outcomes in Obesity Management Among Individuals Using GLP-1 and Dual GLP-1/GIP Receptor Agonist Therapy: Retrospective Cohort Service Evaluation Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="31",
volume="27",
pages="e69466",
keywords="obesity; weight loss; semaglutide; tirzepatide; digital health; engagement; behavior; coaching; retrospective study; service evaluation",
abstract="Background: Obesity is a global public health challenge. Pharmacological interventions, such as glucagon-like peptide-1 (GLP-1) receptor agonists (eg, semaglutide) and dual GLP-1/gastric inhibitory polypeptide receptor agonists (eg, tirzepatide), have led to significant weight loss among users. Digital health platforms offering behavioral support may enhance the effectiveness of these medications. Objective: This retrospective service evaluation investigated the impact of engagement with an app-based digital weight loss program on weight loss outcomes among individuals using GLP-1 receptor agonists (semaglutide) and dual GLP-1/gastric inhibitory polypeptide receptor agonists (tirzepatide) in the United Kingdom over 5 months. Methods: Data were collected from the Voy weight loss digital health platform between February 2023 and August 2024. Participants were adults aged 18-75 years with a BMI ≥30 or ≥27.5 kg/m2 with the presence of obesity-related comorbidities who initiated a weight management program involving semaglutide or tirzepatide. Engagement was defined based on attendance at coaching sessions, frequency of app use, and regular weight tracking. Participants were categorized as ``engaged'' or ``nonengaged'' accordingly. Weight loss outcomes were assessed over a period of up to 5 months. Statistical analyses included chi-square tests, independent t tests, Kaplan-Meier survival analysis, and calculations of Cohen d for effect sizes. Results: A total of 57,975 participants were included in the analysis, with 31,407 (54.2{\%}) classified as engaged and 26,568 (45.8{\%}) as nonengaged. Engaged participants achieved significantly greater weight loss at each time point. At month 3, engaged participants had a mean weight loss of 9{\%} (95{\%} CI 9{\%} to 9.1{\%}) compared with 5.9{\%} (95{\%} CI 5.9{\%} to 6{\%}) in nonengaged participants (P<.001), representing a mean difference of 3.1 percentage points (95{\%} CI 3.1{\%} to 3.1{\%}). A Cohen d effect size of 0.89 indicated a large effect. At month 5, engaged participants had a mean weight loss of 11.53{\%} (95{\%} CI 11.5{\%} to 11.6{\%}) compared with 8{\%} (95{\%} CI 7.9{\%} to 8{\%}) in the nonengaged participants (P<.001). A Cohen d effect size of 0.56 indicated a moderate effect. Participants using tirzepatide achieved more significant weight loss than those using semaglutide at month 5 (13.9{\%}, 95{\%} CI 13.5{\%} to 14.3{\%} vs 9.5{\%}, 95{\%} CI 9.2{\%} to 9.7{\%}; P<.001). The proportion of engaged participants achieving ≥5{\%}, ≥10{\%}, and ≥15{\%} weight loss was significantly higher than the nonengaged group at corresponding time points from months 3 to 5 respectively (P<.001). Conclusions: Engagement with a digital weight management platform significantly enhances weight loss outcomes among individuals using GLP-1 receptor agonists. The combination of pharmacotherapy and digital behavioral support offers a promising strategy to promote the supported self-care journey of individuals seeking clinically effective obesity management interventions. ",
issn="1438-8871",
doi="10.2196/69466",
url="https://www.jmir.org/2025/1/e69466",
url="https://doi.org/10.2196/69466"
}