JMIR Publications

ABSTRACT

Background:

Digital weight management interventions have the potential to increase access to novel pharmacotherapy for people living with obesity. At present, there is limited real-world evidence on the effectiveness, feasibility and acceptability of this type of intervention.

Objective:

This retrospective study examined real-world data to evaluate the preliminary impact of Second Nature’s 24-month, remotely-delivered, semaglutide-supported weight management intervention for adults living with obesity at 12 weeks.

Methods:

Retrospective data were extracted in October 2023 for participants who started the intervention between 08/06/2023 and 22/07/2023. The primary outcomes were weight change in kg and percentage weight change at 12 weeks. Secondary outcomes were the proportion of participants who achieved ≥5% and ≥10% weight loss, and the feasibility and acceptability of this type of intervention. Descriptive statistics were used to evaluate baseline characteristics, retention, engagement, prevalence of side effects and weight change. A two-tailed t-test was used to determine the significance of weight change. Content analysis was used to analyze free-text questionnaire responses.

Results:

A total of 113 participants with a mean baseline BMI of 38.4 kg/m2 (SD 7.3) were included in the analysis (90.4% female, mean age 46.6 years (SD 11.1)). Over 12 weeks, a total of 23% (n=26) of participants withdrew from the intervention. A total of 70.8% (n=80) of participants provided weight data at 12 weeks. The average weight loss observed over this 12-week period was 6.5 kg (P<.001, SD 4.4) or 6.4% of their starting weight (P<.001, SD 4.2). Of the 80 participants who recorded weight readings, 62.5% (n=50) achieved ≥ 5% weight loss and 11.3% (n=9) achieved ≥ 10% weight loss. Engagement with the app-based program declined from a mean of 131 home screen views in week 0 (SD 142.6) to 35 in week 11 (SD 57.1). Common side effects reported over 12 weeks included feeling more tired than usual, constipation and feeling sick, however, a significant proportion of participants reported no side effects. The majority of participants (93.8%, n=106) did not experience difficulties with medication administration. Qualitative data showed that most participants had a positive or neutral experience of the intervention so far, with some reporting perceived benefits as early as four weeks. Most participants did not feel that improvements to the intervention were needed, however, some faced issues with medication shipping or logistics.

Conclusions:

This retrospective analysis of preliminary, real-world data suggests that a remotely-delivered semaglutide-supported weight management intervention is effective, feasible and acceptable for adults with obesity in the UK. Areas for further improvement were highlighted, including user engagement in an app-based program. A full evaluation at the end of the 24-month intervention is required to support these early findings.