Long-term health and economic impact of using digital tool Gro Health W8Buddy to support people accessing specialist weight management services.

Background In the UK, 25% of men and 26% of women live with obesity.

NHS offers specialist weight management service (WMS) for people living with severe obesity (BMI above 40 kg/m2 or over 35 kg/m2 with co-morbidities, e.g., diabetes, hypertension).

The population eligible for referral to WMS vastly supersedes current capacity (~ 4million eligible but 35,000 capacity). The efficacy of WMS has been modest with 50% of patients achieving 5% weight loss over 6-12 months. Last year medication Wegovy received approval for use in WMS, following clear evidence of its weight loss efficacy.

Innovative approaches are needed to provide efficient and timely treatment pathways in WMS, increase access to pharmacotherapy for people living with obesity, and reduce existing health inequality. Intervention Digital tools used in WMS enhance weight loss and can be used to deliver weight loss pharmacotherapy.

However, long-term real-world evidence (RWE) needs to be generated to enable accelerated uptake of digital interventions delivering pharmacotherapy within NHS WMS pathways in a safe and efficient way.

Gro Health W8Buddy (created by DDM) offers personalised digital pathway delivering pharmacotherapy and remote support by healthcare professionals and received NICE EVA in 2023 as a digital technology for WMS.

Objective This study aims to generate longitudinal RWE from NHS WMS using the digital pathway Gro Health W8Buddy to inform future practice and policy.

We want to assess long-term (18 months) impact on clinical outcomes, including health-related quality of life and cost-effectiveness of using digital pathway Gro Health Buddy, and compare it with traditionally delivered face-to-face WMS.

Methods In this prospective comparative cohort RWE study with embedded cost-effectiveness analysis and process evaluation, we will recruit 450 participants across 4 NHS sites.

The sites include University Hospital Coventry and Warwickshire (UHCW), University Hospital Birmingham (UHB), London Barts Trust (LBT) and Hywel Dda University Health Board Trust (HDUHBT), covering regions with higher than national average of deprivation, a diverse ethnicity make-up and higher obesity rates.

Participants will be able to choose whether to receive standard of care (face-to-face WMS including pharmacotherapy where available) or the digital pathway (Gro Health W8Buddy with pharmacotherapy where available). Qualitative methodology will be used alongside quantitative data collection as part of process evaluation.

We will engage with all stakeholders and have significant patient and public input throughout the study to determine how to implement the digital innovation effectively and scale it nationally.

In this 36-month study we will report on outcome data at 18 months and will continue data collection on patients beyond the study period to generate long-term evidence.