A retrospective cohort compared 12-month weight change between two pathways of a telemedicine obesity programme. Of 4,269 adults, 1,658 received individualised carbohydrate-reduced nutrition therapy alongside incretin medication, and 2,611 received medication and behavioural coaching without structured nutrition therapy. Among GLP-1-naive tirzepatide users, adjusted 12-month weight loss was 45.9 lb with nutrition therapy against 34.4 lb without. On semaglutide the equivalent adjusted figures were 30.7 lb and 24.1 lb. About 80% of participants in both pathways had a proportion of days covered of at least 80%. Participants were not randomised to the two pathways, so motivation and engagement may differ between the groups.
Why it is interesting: The trials established what incretin drugs do; this adds a figure for the increment from structured diet alongside them in routine care.
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