Psychosocial Outcomes in Telemedicine and Long-Acting Incretin-Specific Behavioral Intervention.

Abstract

Background: Newer generation anti-obesity medications such as semaglutide and tirzepatide are highly efficacious, resulting in a proliferation of telehealth prescribers. Few, however, augment medication with a behavioral intervention, and little research has examined the impact of these medications on psychosocial variables.

Objective: This study evaluated the efficacy of a telehealth provision of semaglutide/tirzepatide with a virtual behavioral program on psychosocial outcomes at 12 and 24 weeks.

Methods: In this single-arm pragmatic trial, 180 participants (M age = 44.1; 91% female; 81% white; M weight = 102.6 kgs) were recruited from a telemedicine obesity program (WeightWatchers Clinic) and offered an adjunctive virtual behavioral program tailored for patients on long-acting incretin therapy. Participants completed the PHQ-8 measuring depression, Perceived Stress Scale, Self-Compassion Scale, WHO-5 measuring well-being, Weight Bias Internalization Scale-2F and Impact of Weight on Quality of Life-Lite at baseline, 12 and 24 weeks. Wilcoxon signed-rank tests were conducted to evaluate outcome differences. p values were adjusted using a False Discovery Rate approach. Intent-to-treat analysis was performed using last observation carried forward (LOCF).

Results: There were significant improvements from median baseline to 24 weeks in measures of depression (-2), perceived stress (-3), well-being (3), weight bias internalization (-0.6), and impact of weight on quality of life (-18). All p's < 0.001 in the baseline to 24-week analyses with similar results shown at 12 weeks.

Conclusions: Virtually delivered obesity treatment combining telemedicine and a long-acting incretin-specific behavioral program demonstrated clinically significant improvements in psychosocial outcomes over 24 weeks.