Digital engagement enhances dual GIP / GLP ‐1 receptor agonist and GLP ‐1 receptor agonist efficacy: A retrospective cohort analysis of a digital weight loss service on outcomes and safety

Oct 27, 2025Diabetes, obesity & metabolism

Digital support improves the effectiveness and safety of dual GIP/GLP-1 and GLP-1 treatments for weight loss

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Abstract

Engaged patients in a digital weight loss service achieved 4.5 percentage points greater weight loss compared to those not engaged.

79.7% of the cohort utilized the digital application, but only 5.7% achieved maximal engagement.
Over 11 months, engaged participants lost an adjusted weight of 21.5% compared to 17.0% for non-engaged participants.
Engaged patients demonstrated higher likelihoods of reaching weight loss milestones: ≥5% (HR 1.42), ≥10% (HR 1.46), ≥15% (HR 1.53), ≥20% (HR 1.62), and ≥25% (HR 1.86), all with p < 0.001.
Safety analysis indicated an incidence rate of 1.57 per 1000 patient-months, with no increased risk in engaged groups (IRR 0.83).

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AIMS: We evaluated the weight loss efficacy and safety of a national digital weight loss service (DWLS) and explored associations between digital engagement and outcomes in adults prescribed dual GIP/GLP-1RA and GLP-1RA.

MATERIALS AND METHODS: We conducted a retrospective longitudinal cohort analysis of adults prescribed dual GIP/GLP-1RA and GLP-1RA between August 2024 and July 2025 within the Voy DWLS in the United Kingdom (UK). Digitally engaged patients met all three criteria: (i) ≥1 coaching session; (ii) weekly weight logging (≥4/month); and (iii) ≥1 additional in-app interaction. Weight-loss trajectories were modelled using mixed models for repeated measures (MMRM). Kaplan-Meier methods and Cox models examined time to attain weight loss thresholds (≥5, ≥10, ≥15, ≥20, ≥25%). Safety events were summarised as rates per 1000 patient-months with 95% CIs.

RESULTS: The cohort included 106 653 adults (mean age 42.3 ± 12.7 years; 77.9% female; baseline BMI 35.2 ± 6.2 kg/m). Whilst 79.7% (n = 84 955) used the digital application, 5.7% (n = 6086) met maximal engagement, with 100 567 classed as not engaged. Across 11 months, engaged patients achieved greater adjusted weight loss than not engaged (21.5% [95% CI -22.0 to -21.1] vs. 17.0% [-17.2 to -16.8]; absolute difference 4.5 percentage points; p < 0.001). Kaplan-Meier analyses showed consistently higher likelihood of milestone attainment for engaged participants (≥5%: HR 1.42, 95% CI 1.38-1.46; ≥10%: HR 1.46, 1.41-1.52; ≥15%: HR 1.53, 1.45-1.61; ≥20%: HR 1.62, 1.50-1.75; ≥25%: HR 1.86, 1.64-2.10; all p < 0.001). Safety analyses over 290 050 patient-months showed incidence 1.57 per 1000 patient-months, with no excess risk in engaged groups (IRR 0.83, 95% CI 0.60-1.15). 2

CONCLUSIONS: Digital engagement was associated with 4.5 percentage points greater weight loss (21.5% vs. 17.0%), faster milestone achievement, and comparable safety profiles.

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Digital engagement enhances dual GIP / GLP ‐1 receptor agonist and GLP ‐1 receptor agonist efficacy: A retrospective cohort analysis of a digital weight loss service on outcomes and safety

Abstract

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