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Treat to Target in Weight Management with Semaglutide: Real-World Evidence from an eHealth Clinic
15 Pages Posted: 10 Apr 2025
More...Abstract
BackgroundNo study has assessed the effectiveness of a personalized treat-to-target approach for weight loss through tailored obesity medication doses in participants living with overweight or obesity. We therefore aimed to evaluate the effectiveness of an online multidisciplinary weight loss service combining personalized semaglutide doses with intensive behavioral therapy (IBT).MethodsThis retrospective cohort study was based on the Danish database of participants treated with semaglutide and IBT including personalized evidence-based recommendations on nutrition, exercise and habits through an online app (The Embla app). The program is available for adult individuals living with overweight or obesity in Denmark. All contact with participants, data collection, and monitoring was conducted via the Embla app during the period December 2022 to September 2024. The primary outcome was percentage change in body weight at week 64. Secondary outcomes were use of semaglutide, proportion of participants achieving ≥5%, ≥10%, ≥15%, or ≥20% weight loss, and percentage change in body weight according to baseline BMI and semaglutide dosing.FindingsThe study included 2694 participants, of which 2100 (78%) were women, mean [SD] age was 46.8 [10·8] years, and mean BMI was 34·3 [4·8]. After 26, 52 and 64 weeks, respectively, 1580, 712 and 465 participants were still included. Participants had a mean weight loss of -16·7% (95%CI, -17·4 to -16·0) after 64 weeks, with a mean semaglutide dose of 1·08 mg/week (SD 0·54). 98% and 83% of the participants achieved weight loss of at least 5% and 10%. The percentage change in body weight was similar across baseline BMI class subgroups and across mean medication doses.InterpretationParticipants in the Embla online clinic achieved weight loss of a magnitude similar to those reported in confirmatory randomized controlled trials but with less than half of the medication used. Similar mean weight loss was observed across BMI classes and all medication doses. These results highlight the effectiveness of a personalized, treat-to-target approach to medical obesity management in combination with individualized coaching.
Keywords: Obesity, Digital Health, Weight Management, RWE, RWD
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