SUN-704 - Real-World Weight Loss Outcomes with GLP-1RA Therapy: Engagement vs No Engagement in A Tailored Behavioral Program

Background: Several glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been approved for obesity treatment as an adjunct to lifestyle change. Yet, limited research exists evaluating whether lifestyle change improves weight outcomes beyond medication alone. As adoption expands, digital weight management programs offer a scalable approach to provide structured nutrition, activity, and behavioral support alongside medication.

Objective: Evaluate weight loss outcomes among patients of a digital weight management program prescribed a GLP-1RA who do and do not regularly engage with GLP-1RA-tailored behavioral support.

Methods: A retrospective observational study was conducted evaluating patients with a starting BMI≥27 kg/m2 who enrolled in a digital weight management program (Weight Watchers Med+) and initiated GLP-1RA treatment, requested ≥1 refill, and had weights at baseline and at least one assessment point: week 4, 13, 26, or 52. Patients were offered an app-based GLP-1RA-tailored behavioral program, providing personalized nutrition targets along with food, activity, and weight tracking. Propensity score matching was used to create two comparable cohorts based on age, sex, and baseline BMI at 4 timepoints who (1) engaged regularly with the GLP-1RA-tailored behavioral program (≥4 days/week), or (2) never logged into the behavioral program. Mean weight changes were computed at weeks 4, 13, 26, and 52.

Results: Cohorts were matched at weeks 4 (n=2,101/group); 13 (n=2,244/group); 26 (n=1,027/group); and 52 (n=374/group). Across all cohorts, patients were predominantly female (92-96%), with a mean age of 46-55 years and mean BMI of 36-38 kg/m2. At all timepoints, patients who engaged with the GLP-1RA-tailored behavioral program lost significantly more weight than those who did not (p’s < 0.001). At week 4, engaged patients lost a mean 4.3% body weight (95% CI: -4.4%, -4.2%; 4.3 kg), and those who did not engage lost 2.8% (95% CI: -2.9%, -2.7%; 2.8 kg). At week 13, engaged patients lost a mean 9.1% body weight (95% CI: -9.3%, -9.0%; 9.3 kg), and those who did not engage lost 6.6% (95% CI: -6.7%, -6.4%; 6.6 kg). At week 26, engaged patients lost a mean 15.1% body weight (95% CI: -15.4%, -14.7%; 15.5 kg), and those who did not engage lost 11.4% (95% CI: -11.7%, -11.0%; 11.6 kg). At week 52, engaged patients lost a mean 22.3% body weight (95% CI: -23.1%, -21.5%; 23.2 kg), and those who did not engage lost 17.8% (95% CI: -18.6%, -17.0%; 18.3 kg).

Conclusion: Engagement in a real-world, GLP-1RA-tailored behavioral program resulted in greater early and 52-week weight loss outcomes compared with no behavioral support. These findings underscore the benefit of behavioral support in enhancing clinical impact beyond medication alone. Digital weight management programs offer a scalable model to integrate medication management and tailored lifestyle support amid increasing GLP-1RA uptake.

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