Currently submitted to: JMIR Formative Research
Date Submitted: Feb 14, 2025
Open Peer Review Period: Feb 15, 2025 - Apr 12, 2025
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Remotely Delivered, GLP-1RA-Supported Specialist Weight Management Program: 12 Month Outcomes From a Retrospective Service Evaluation
ABSTRACT
Background:
Limited access to specialist weight management services (SWMS) restricts the implementation of novel obesity pharmacotherapy in the United Kingdom’s (UK) National Health Service (NHS). Remote delivery of GLP-1 receptor agonist (GLP-1RA) medication with digital behavioural support could provide a scalable solution, but evidence for long-term effectiveness is limited
Objective:
To evaluate the effectiveness, feasibility, acceptability and potential cost-effectiveness of Second Nature's remotely-delivered, semaglutide-supported weight management program over 12 months
Methods:
Retrospective data were extracted for participants who initiated the intervention between September and December 2023. Primary outcome was weight change at 12 months. Secondary outcomes included behavioral changes, side effects, program engagement, participant experience and comparative cost analysis against NHS SWMS. Descriptive statistics and paired two-tailed t-tests evaluated outcomes. Content analysis was used for qualitative data.
Results:
Of 341 participants (82.8% women; mean age 49.0 years, SD 11.1; mean baseline BMI 37.9 kg/m², SD 6.9). Participants with active subscriptions (39.6%, n=135) achieved 20.0 kg (19.1%, SD ,P<.001) loss versus 12.4 kg (11.9%) for inactive subscriptions. Overall, 77.7% achieved ≥10% weight loss and 61.5% achieved ≥15%. Program engagement declined from 113 (SD 78.4) home screen views in month 1 to 25 (SD 29.06) in month 12. Side effects decreased over time, with 69.6% reporting none by month 12. Most participants reported positive (34.2%) or neutral (56.7%) experiences at 12 months. The intervention costs were estimated at 30-40% of current NHS SWMS, projecting potential savings of £1.5m-£1.8m per 100,000 population
Conclusions:
This evaluation suggests that remotely-delivered GLP-1RA-supported weight management can be effective, feasible, acceptable and cost-effective for people living with obesity. Further research within public healthcare settings is needed to evaluate clinical outcomes and assess sustained results with continuation and discontinuation of medication.
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