Engagement and Weight Change in an Online Weight Management Program in Clinical Settings: An Implementation Project

BACKGROUND: There is an urgent need for scalable strategies for treatment of overweight and obesity that can be implemented in clinical settings. OBJECTIVE: To implement and evaluate an online weight management program in a large, diverse population of patients. DESIGN: Clinical implementation project in primary care and specialty clinics. PARTICIPANTS: plus ≥ 1 cardiovascular risk factor or obesity-related condition. INTERVENTION: Enrolled patients were encouraged to register for a 12-month digital health program called RestoreHealth, which included an online program/app and coaching. MAIN MEASURES: We examined recruitment and enrollment in the program, as well as engagement, absolute and percent weight change, and predictors of weight change during the first six months. Subgroup analyses were conducted by use of anti-obesity medications. KEY RESULTS: A total of 5056 patients enrolled between November 2022 and October 2023, and 4511 (89.2%) completed registration for RestoreHealth. At six months, mean absolute and percent weight change among all enrolled patients were -5.7 pounds and -2.5%, respectively (p < 0.0001 for both), and 27.7% of patients lost ≥ 5% of their body weight. There was greater weight loss among patients using anti-obesity medications (mean absolute and percent weight change = -12.5 pounds and -5.5%, respectively). Among registered patients, 91.8% engaged in the program, although engagement decreased over time. Older age, greater weight at enrollment, and longer duration of engagement were associated with greater weight loss. CONCLUSIONS: We rapidly enrolled a large, diverse population of patients in PROPS 2.0. Patients lost weight at six months, with greater weight loss among those using anti-obesity medications. This program has the potential to be scaled and implemented at other institutions in the future. GOV REGISTRATION NUMBER: NCT05553925 (initial release date August 18, 2022).