JMIR Publications

ABSTRACT

Background:

The escalating prevalence of obesity worldwide increases the risk of chronic diseases and diminishes life expectancy with growing economic burden necessitating urgent intervention. The existing tiered approach to weight management, particularly specialist Tier 3 services, falls short of meeting the population's needs. The emergence of digital health tools, while promising, lacks exploration in specialized NHS weight management services (WMS).

Objective:

Our primary objective was to assess uptake and engagement of patients with the W8Buddy. Our secondary objective was to assess clinical effectiveness of W8Buddy via changes in weight, HbA1c and mental health outcomes.

Methods:

This was a service evaluation study to assess the use, effectiveness and clinical impact of the W8Buddy digital support tool as part of NHS WMS. W8buddy is a personalized digital platform, providing a tailored weight management plan to empower individuals, and was collaboratively developed with input from patients, clinical team and Diabetes Digital Media. It was launched at University Hospitals Coventry and Warwickshire (UHCW) Tier 3 WMS in 2022. All patients accessing UHCW WMS were offered W8buddy as part of standard of care. Data were analysed using independent samples t-tests and Fisher exact tests, for continuous and categorical outcomes respectively. Multiple linear regression analysis was used to explore associations between a participant’s weight, engagement with W8Buddy and time in the service.

Results:

Complete datasets for weights were available for 421 patients (220 W8Buddy group, 192 non-users-control group). W8buddy users, predominantly female (84%) and Caucasian, had a mean age of 43 years, while non-users averaged 46 years (P=0.02). Starting weights were comparable with 134 kg and 130.2 kg in W8Buddy and control group respectively (P=0.142), however, W8Buddy group had slightly higher starting BMI compared to the control group (49.6 and 46.8 kg/m2 respectively, P=0.08). 33.5% of all patients activated W8Buddy and engaged with it. There was a significant weight loss in participants using W8Buddy, with a 0.74kg monthly loss compared to standard care (β -0.74, 95%CI (-1.28, -0.21), P=0.007). The longer an individual stayed in the study and used W8Buddy, the more weight was lost. W8buddy users with type 2 diabetes (T2DM) experienced a significant HbA1c reduction (59.8 mmol/mol to 51.2 mmol/mol, P=0.018) compared to non-users with T2DM. W8Buddy users showed significant improvement across satisfaction with life scale, Karolinska sleepiness scale and quality of life visual analogue scale (P<0.001) during follow-up.

Conclusions:

Participants engaging with W8Buddy as part of digitally enabled Tier 3 WMS demonstrated significant improvements in clinical and psychological outcomes. These findings suggest that digital tools can augment traditional services and promote patient empowerment. Future study needs to provide long term data to understand if any benefits from digital tool are sustained.