The Impact of Technology-Enabled Medical Nutrition Therapy on Weight Loss in Adults With Overweight and Obesity: Retrospective Observational Study.

Abstract

Background: Obesity represents a major public health crisis in the United States, imposing substantial health risks and economic costs. Medical nutrition therapy (MNT) is an evidence-based treatment where a registered dietitian provides personalized nutrition and lifestyle guidance to patients. MNT has been demonstrated to be effective for weight loss and managing chronic diseases in patients with obesity. With the rise of telehealth, MNT has gained popularity as an accessible alternative to traditional in-person care. While a nationwide program integrating MNT with a companion mobile app offers a comprehensive weight management solution, data supporting its clinical effectiveness is limited.

Objective: This study aimed to evaluate the effectiveness of an MNT program with a companion mobile app on weight loss among adults with overweight and obesity.

Methods: This retrospective cohort study included users of Nourish, an MNT program with a companion mobile app, who attended at least 1 appointment between August 2023 and October 2024 and had a baseline BMI≥30 kg/m² or a BMI between 27-30 kg/m² with diabetes or prediabetes. The primary outcome was the proportion of participants who achieved at least 5% weight loss; secondary outcomes included mean weight change, mean percent weight change, and the proportion of participants who achieved at least 3% weight loss. Statistical significance of weight change was determined using 2-tailed t tests. Subgroup analyses were performed by sex, BMI, follow-up time between weights, number of appointments completed, and levels of engagement according to appointment frequency and app usage.

Results: In total, 3951 participants were included in the analysis. The mean age was 38 (SD 10) years, and 78% (3082/3951) of participants were female. Weight loss was reported as a program goal by 70% (2748/3951) of participants, while 31% (1204/3951) and 24% (939/3951) reported diabetes or prediabetes and a cardiovascular condition, respectively. Over a median follow-up of 2.2 months, 17% (689/3951) of participants achieved at least 5% weight loss. The mean weight change was -4.5 (SD 8.9) pounds, corresponding to a mean percent weight change of -2% (SD 3.9; P<.001). Males and participants aged 60 years or older were more likely to experience at least 5% weight loss. Longer follow-up time between weights and a higher number of completed appointments (≥5 appointments) were significantly associated with a significantly higher likelihood of achieving at least 5% weight loss (P<.001 for both). In addition, participants who were most engaged, based on appointment frequency and app usage, were more likely to achieve at least 5% weight loss compared with those who were less engaged (P<.001).

Conclusions: Engagement with an MNT program and companion mobile app is associated with significant weight loss for adults with overweight and obesity and may serve as an effective, scalable weight management solution.