Evaluation of the digital support tool Gro Health W8Buddy as part of Tier 3 Weight Management Service

Introduction The escalating prevalence of obesity worldwide increases the risk of chronic diseases and diminishes life expectancy with growing economic burden necessitating intervention.1 The existing tiered approach to weight management, particularly specialist Tier 3 services, falls short of meeting the population's needs. The emergence of digital health tools, while promising, lacks exploration in specialised NHS weight management services (WMS). Methods This was a service evaluation study to evaluate the effectiveness and clinical impact of the W8Buddy digital support tool as part of a specialist WMS. W8buddy was collaboratively developed September 2022 with input from patients and clinical teams. It is a personalised platform, offering users a tailored weight management plan to empower individuals or caregivers to cultivate the necessary attitudes, knowledge, and skills to self-manage their health. All patients accessing the service were offered W8buddy and everyone received standard of care regardless of whether they used the digital tool. No financial incentives were given for using W8Buddy. Results Complete data was available for 226 patients (118 users, 108 non-users). W8buddy users, predominantly female (80%) and Caucasian (76%), had a mean age of 42 years, while non-users averaged 48 years (p = 0.01). Co-morbidity frequencies were comparable between users and non-users. Users had significantly higher baseline weight (135 kg vs. 123 kg, p = 0.003) and BMI (48 kg/m² vs. 45 kg/m², p = 0.009). During follow-up (3 months for users, 6 months for non-users), 28% (n = 220/783) activated the tool by June 2023, of which 93% (n = 205/220) actively engaged with the platform. W8Buddy demonstrated a substantial impact on absolute weight loss (β -1.16, SE 0.40, p = 0.004) compared to standard care alone. Time using W8Buddy was a crucial predictor of weight loss (p = 0.05), with a 0.74 kg monthly loss compared to standard care (β -0.74, 95%CI (-1.28, -0.21), p = 0.007). W8buddy users with type 2 diabetes (T2DM) experienced a significant HbA1c reduction (59.8 mmol/mol to 51.2 mmol/mol, p = 0.018) compared to non-users with T2DM. Optional surveys evaluating psychological outcomes included satisfaction with life, PHQ8, Karolinska scale, and quality of life score (EQ5D5L). W8Buddy users showed significant improvement across all psychological outcomes (p<0.001) during follow-up. Conclusion W8Buddy demonstrated significant improvements in clinical and psychological outcomes for users. Integrated use of W8buddy enhances weight loss, especially with extended treatment. The tool seems to foster positive changes in lifestyle and health management, which are reflected in the improvements in glycaemic control, mental wellbeing, and perceived quality of life. These findings suggest that digital tools can complement traditional services and promote patient empowerment and self-management. Future research should explore the key beneficial aspects of the tool for users and strategies to boost activation and engagement rates. Endorsed by National Institute for Health and Care Excellence (NICE) guidelines, W8Buddy holds promise for improved weight management and glycaemic control within specialized WMS.