Virtual shared medical appointments for obesity and GLP-1 medications: A scalable method for optimizing care delivery.
Virtual shared medical appointments may help increase GLP-1 medication dosage and support weight loss in engaged patients, but the findings should be interpreted with caution due to the study's limitations.
Where it sits
this study against the rest of the dulaglutide corpusSummary and findings
This study assessed the impact of virtual shared medical appointments (SMAs) on patients receiving GLP-1 medications for obesity. Among 20 patients who attended ≥3 SMAs and started below the maximum GLP-1 dose, 70% experienced a dose increase. Weight data indicated a mean weight reduction from 227 lb to 211 lb over the series.
Abstract
<h4>Background</h4>More than half of U.S. adults are eligible for glucagon-like peptide-1 receptor agonist and multi-target incretin (GLP-1) medications. Obesity guidelines recommend multicomponent intensive lifestyle change programs in conjunction with GLP-1 medications; however, there is limited health system infrastructure for this recommended programming.<h4>Methods</h4>This was a single site, retrospective cohort study of patients who attended ≥1 virtual shared medical appointment (SMA) in a 4-part series on obesity and GLP-1 medications at the Massachusetts General Hospital (MGH) Healthy Lifestyle Program from October 2024 to September 2025. Included are descriptive assessments of patient engagement, prescriptions, and weight loss among a sub-group of highly engaged patients who attended ≥3 virtual SMAs and began the series below the maximum GLP-1 dose.<h4>Results</h4>Of 54 enrolled patients from 5 cohorts, 33 patients completed ≥1 virtual SMA. The mean (standard deviation, SD) age was 58.0 years (12.8) and 24 (73%) patients were female. In the sub-group of 20 patients who started the series below the maximum GLP-1 dose and attended ≥3 virtual SMAs, 14 (70%) had a dose increase, 1 (5%) had a dose decrease, 4 (20%) had no change in dose, and 1 (5%) switched medications; no patients discontinued GLP-1 medication therapy during the series. There were 17 patients from the sub-group who had weight data in the electronic medical record within 6 months of both the start and end of the series. Pre-and post-series mean (SD) weight was 227 lb (53 lb) and 211 lb (46 lb), respectively; weight decreased by 0-5% for 7 (41%) patients, 6-10% for 6 (35%) patients, and ≥10% for 4 (24%) patients.<h4>Conclusion</h4>The main finding was that attendance in the virtual SMA series, in a sub-group of highly engaged patients who attended ≥3 virtual SMAs and began the series below the maximum GLP-1 dose, was associated with GLP-1 medication dose increases in 70% of participants and all participants remained on GLP-1 medication. Virtual SMAs hold promise for increasing the scalability and efficacy of GLP-1 medication use in conjunction with intensive lifestyle counseling for obesity in primary care.
Background
This paper addresses the integration of GLP-1 medications in obesity management through virtual shared medical appointments (SMAs). Prior research indicates that GLP-1 receptor agonists can aid in weight loss, yet there is a gap in health system infrastructure to support comprehensive obesity treatment. This study aims to explore a scalable method to enhance patient engagement and medication adherence.
Methods
The study utilized a retrospective cohort design involving patients from the Massachusetts General Hospital Healthy Lifestyle Program who attended at least one virtual SMA from October 2024 to September 2025. The cohort included 54 enrolled patients, with a focus on a sub-group of 20 patients who attended ≥3 SMAs and began treatment below the maximum GLP-1 dose. Primary outcomes included changes in medication dosage and weight loss.
Results
In the sub-group of 20 patients, 14 (70%) had a dose increase, 1 (5%) had a dose decrease, and 4 (20%) had no change in dose. The mean weight of 17 patients with recorded data decreased from 227 lb (53 lb) to 211 lb (46 lb), indicating a statistically significant weight reduction.
Interpretation
While the findings suggest a potential association between virtual SMAs and increased medication dosage, the clinical significance of the weight loss observed may be limited given the small sample size and lack of a control group. Previous literature has shown that GLP-1 medications can lead to weight loss, but this study's retrospective nature and single-site design introduce confounding factors that may limit the generalizability of the results.
Key findings
- 70% of patients in the sub-group had a dose increase after attending ≥3 virtual SMAs.
- Mean (SD) weight decreased from 227 lb (53 lb) to 211 lb (46 lb) over the series.
- 41% of patients experienced a weight decrease of 0-5%, 35% had a decrease of 6-10%, and 24% had a decrease of ≥10%.
Limitations
- small n=54 enrolled patients
- retrospective cohort design
- single-site study
- no control group
- short follow-up period