TOWARD A Metabolic Health Intervention Demonstrates Robust 1year Weight Loss and Cost-Savings through Deprescription

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TOWARD A Metabolic Health Intervention Demonstrates Robust 1year Weight Loss and Cost-Savings through Deprescription

ORIGINAL RESEARCH article

Front. Nutr.

Sec. Clinical Nutrition

Volume 12 – 2025 |
doi: 10.3389/fnut.2025.1548609

This article is part of the Research Topic Ketogenic Metabolic Therapies in Prevention & Treatment of Non-communicable Diseases View all 8 articles

Provisionally accepted

  • 1 Private Practice, Tappan, United States
  • 2 Harvard Medical School, Boston, Massachusetts, United States
  • 3 No affiliation, New York, United States
  • 4 Edge Hill University, Ormskirk, United Kingdom
  • 5 National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico

The final, formatted version of the article will be published soon.

    Background: Cost, scalability, and durability represent major challenges to the implementation of intensive lifestyle treatments for obesity and diabetes. We previously reported pilot data from a 6month intervention in which a self-insured manufacturing company partnered with a metabolic health clinic that utilizes therapeutic carbohydrate reduction (TCR), asynchronous monitoring, and a community-based approach to treat employees with metabolic disease. This manuscript presents weight loss and cost-savings from deprescription at the 12-month time point.Methods: 50 employees, mean BMI 43.2 ± 8.7 kg/m2, 64% with prediabetes or type 2 diabetes, were enrolled in the multimodal TOWARD telemedicine intervention, which includes: Text-based communications, Online interactions, Wellness coaching, Asynchronous education, Real-time biofeedback and remote monitoring, and Dietary modifications that emphasizes TCR.: 41 completed the one-year intervention. Mean weight loss for the 50 subjects in the intention to treat analysis was 19.5 ± 11.4 kg, corresponding to 15.5% total body weight loss with concomitant deprescription of 96 medications, while starting only 8 medications. In patients who discontinued GLP-1 receptor agonists, weight loss continued or was maintained. Annualised cost savings from the TOWARD approach were approximately $83,285.00.The TOWARD approach represents a scalable metabolic health intervention that demonstrates robust improvements in weight while simultaneously allowing for deprescription leading to substantial cost savings. TOWARD could serve as a scalable tool to facilitate intensive lifestyle intervention with efficacy on par with GLP-1 receptor agonists.

    Keywords:
    diabetes, Ketogenic Diet, Glp1, Obesity, Telemedicine, Therapeutic Carbohydrate Reduction

    Received:
    19 Dec 2024;
    Accepted:
    22 Jan 2025.

    Copyright:
    © 2025
    Buchanan, Calkins, Kalayjian, Norwitz, Teicholz, Unwin and Soto-Mota. This is an open-access article distributed under the terms of the
    Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted,
    provided the original author(s) or licensor are credited and that the
    original publication in this journal is cited, in accordance with accepted
    academic practice. No use, distribution or reproduction is permitted which
    does not comply with these terms.

    * Correspondence:
    Adrian Soto-Mota, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico

    Disclaimer:
    All claims expressed in this article are solely those of the authors and
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