JMIR Publications

ABSTRACT

Background:

Digital weight management interventions (DWMI) have the potential to support existing specialist weight management services in the NHS to increase access to treatment for people living with obesity and type 2 diabetes. At present, there is limited real-world evidence and long-term outcomes on the potential effectiveness of DWMIs to support such services.

Objective:

This study aimed to examine real-world data to evaluate the impact of Second Nature’s 12-month DWMI for patients living with obesity with or without type 2 diabetes, referred from NHS primary care services, on sustained weight loss around two years from baseline.

Methods:

The primary outcomes were weight change in kg and percentage weight change. A secondary outcome was the proportion of participants who achieved >5% and >10% weight loss. Retrospective data were extracted in August 2023 for participants who participated in the program between 01/01/2017 and 01/08/2021. One sample t-tests were used, including for sub-group analyses to assess whether weight change differed by presence of type 2 diabetes, IMD or ethnicity. Last Observation Carried Forward (LOCF) and Baseline Observation Carried Forward (BOCF) imputation methods were used to sensitise findings to missing data.

Results:

A total of 1,130 participants with a mean baseline BMI of 46.3kg/m2 (SD 31.6) were included in the analysis (65% female, mean age 49.9 years (SD 12.0), 339 (31%) participants reported ethnicity data, of which 37.5% were of non-white ethnicities, and 884 (78.2%) participants had type 2 diabetes). A total of 908 (80%) participants completed the 12-week core weight loss phase of the program. For weight change, 281 (24%) recorded weight readings around two years from baseline, with a mean weight loss of 13.8kg (SD 14.2) or 11.8% (SD 11.9; P<.001), 204 (18.1%) participants achieved more than 5% weight loss and 130 (11.5%) participants reached a weight loss exceeding 10%. Sub-group analyses found significant differences in weight change for all ethnicity groups, IMD deciles and type 2 diabetes status.

Conclusions:

Findings suggest that our DWMI has the potential to support people living with obesity and type 2 diabetes to access specialist weight management services in the NHS and achieve clinically significant and sustained weight loss around 2 years from starting the intervention. To optimize the use of our DWMI in supporting such services, further research is needed on integration with multi-disciplinary clinical teams and pharmacotherapy.