A hybrid obesity care that combines physician-directed glucagon-like peptide-1 receptor agonist (GLP-1 RA) treatment and lifestyle coaching via a mobile health app yields meaningful and sustained improvements in weight and metabolic parameters in a real-world setting, as shown in a local study.
The standardized medical weight-loss program has four components. First is goal-setting that involves initial consultations with a physician and a health coach to determine weight-loss targets and health goals, screen for GLP-1 RA eligibility, and establish a baseline biological profile. Second is tailored GLP-1 RA dosing with physician oversight, with follow-ups conducted every 1–3 months. Third is digital integration, wherein a dedicated mobile app serves to both track dietary intake and physical activity and communicate directly to the physician and health coach via text messaging. Last is adaptive lifestyle coaching that leverages real-time heath metrics to push personalized diet and physical activity coaching through the app.
The provision of continuous support through digital coaching is an important component of the program, according to researchers.
“While lifestyle interventions are the cornerstone of obesity management, self-directed efforts often fall short. Structured support is crucial, and hybrid care models integrating digital health technologies with human medical care and coaching have emerged as effective and scalable approaches to enhance personalized lifestyle modification,” they said.
In an ethnically diverse cohort of individuals with overweight or obesity who remained in the program for at least 3 months, weight and BMI declined steadily over time. The mean percentage reduction in weight was 9.2 percent at 6 months, 12.7 percent at 12 months, and 14.7 percent at 18 months. Similarly, BMI decreased from 31.9 kg/m2 at baseline to 28.9, 27.8, and 27.1 kg/m2 at the respective time points. [Int J Obes 2026;doi:10.1038/s41366-026-02062-x]
Over 18 months, marked improvements in metabolic parameters were also observed. Waist-to-hip ratio dropped from 0.83 to 0.80, systolic blood pressure decreased from 108.4 to 95 mm Hg, body fat percentage declined from 38.6 percent to 28.4 percent, and HbA1c was reduced from 5.1 percent to 4.4 percent.
“These changes reinforce that the weight loss achieved had meaningful physiological effects, translating into reductions in established cardiometabolic risk factors. Such improvements are important given the strong links between obesity, hypertension, insulin resistance, and cardiovascular disease,” the researchers noted.
“Participants who engaged more actively with the program through self-logging, time spent in the app, and messaging with health coaches experienced greater improvements in both weight loss and cardiometabolic outcomes,” they added.
Overall, the findings highlight the potential of incorporating behavioural and digital support into pharmacological treatment as an approach to maximizing its long-term impact, especially now that GLP-1 RAs have become more widespread for the treatment of diabetes and obesity, according to the researchers.
The study included 708 participants (mean age 42.1 years, 64.1 percent female) who were enrolled in the hybrid medical weight-loss program. These included residents and nonresidents living in Singapore (51.4 percent Singaporean, 45.5 percent East Asian). They had to either have obesity (BMI of ≥7.5 kg/m² for Asians or ≥30 kg/m² for non-Asians) or be overweight (BMI ≥23 kg/m² for Asians or ≥25 kg/m² for non-Asians) and had at least one weight-related comorbidity (eg, dyslipidaemia, hypertension, hyperglycaemia).
In terms of program engagement, the odds of having monthly consultations with the health coach were lower among men than women (odds ratio [OR], 0.61, 95 percent confidence interval [CI], 0.44–0.85). Meanwhile, the odds of engaging via text messages were higher among Singaporeans vs non-Singaporeans (OR, 2.07, 95 percent CI, 1.32–3.29) and lower among participants with vs without hyperglycaemia (OR, 0.50, 95 percent CI, 0.31–0.82).
“Further research is needed to better understand what drives or limits engagement across different subgroups and to inform strategies for more tailored and equitable implementation,” the researchers said.