What question did this study set out to answer?

Investigate if digital health engagement enhances weight loss in individuals with type 2 diabetes starting GLP-1RA therapy.

June 7, 2026

1661-P: Digital Programme Engagement Enhances GLP-1 Receptor Agonist Weight Loss Outcomes in Type 2 Diabetes

Key Points

Investigate if digital health engagement enhances weight loss in individuals with type 2 diabetes starting GLP-1RA therapy.
Retrospective cohort study (2022-2025) of adults with T2D starting tirzepatide or semaglutide.
Participants were stratified by digital engagement levels, with full engagement defined by various tracking metrics.
MMRM modeling and Cox regression used to assess weight change and milestones achieved.
Fully engaged participants lost −19.5% of weight versus −14.6% in not-engaged (p<0.001).
60.1% of engaged versus 29.0% of not-engaged achieved ≥10% weight loss, HR 2.44 (95% CI 2.22-2.69), p<0.001.
51.3% versus 21.1% achieved ≥15% weight loss, HR 2.18 (95% CI 1.93-2.47), p<0.001.

Abstract

Introduction and Objective: Individuals with type 2 diabetes (T2D) typically achieve attenuated weight loss with GLP-1 receptor agonists (GLP-1RAs). We investigated whether comprehensive digital health engagement improves weight loss trajectories in people with T2D initiating GLP-1RA therapy. Methods: This retrospective cohort included adults with T2D (18-75 years; BMI ≥30 kg/m² or ≥27.5 kg/m² with comorbidities) initiating tirzepatide or semaglutide through a UK digital weight management service (2022-2025) over 12 months. Patients were stratified by engagement. Full engagement was defined as remote coaching attendance, weight tracking ≥4/month, and app utilisation. Percentage weight change over 12 months was modelled using MMRM adjusted for age, baseline weight, and comorbidities. Cox regression assessed time to ≥10%, ≥15%, and ≥20% weight loss with hazard ratios (HR). Results: Among 7,642 adults with T2D (age 52.8±12.1 years; 71.8% female; BMI 36.9±7.0 kg/m²), 1,011 (13.2%) were fully engaged. Twelve-month adjusted weight loss was −19.5% (95% CI −20.4, −18.7) in engaged versus −14.6% (−15.2, −13.9) in not-engaged participants, a difference of 5.0 percentage points (p0.001). Engagement was strongly associated with accelerated milestone attainment: ≥10% HR 2.44 (95% CI 2.22-2.69), ≥15% HR 2.18 (1.93-2.47), ≥20% HR 2.02 (1.70-2.41); all p0.001. By month 12, 60.1% of engaged versus 29.0% of not-engaged participants achieved ≥10% weight loss, while 51.3% versus 21.1% achieved ≥15% weight loss. Conclusion: Full digital programme engagement yielded greater weight loss and doubled the likelihood of achieving clinically meaningful thresholds in people with T2D, demonstrating that structured digital support substantially improves GLP-1RA treatment outcomes in this population. Disclosure H. Johnson: Employee; Current; Voy t/a Menwell LTD. D. Reisel: Employee; Current; Voy t/a Menwell LTD. D. Huang: Employee; Current; Voy t/a Menwell LTD.

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Cite This Study

JOHNSON et al. (Fri,) studied this question.

synapsesocial.com/papers/6a250cd27def13d035e1cf5f https://doi.org/https://doi.org/10.2337/db26-1661-p

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