Treating Obesity At Scale: Real-World Outcomes Using Medication And Intensive Lifestyle Intervention

Newly published research finds Calibrate’s standard of care effectively treats obesity at scale 

Obesity is the largest category of chronic disease and a major driver of healthcare costs. Over 40% of Americans are living with obesity, and this number is forecasted to be closer to 50% by 2030.(1) This growing healthcare crisis requires immediate action. 

Despite the gravity of the obesity epidemic, legacy obesity treatments have either failed to produce effective results, or have failed to be widely adopted. Of the 100M people living with obesity, less than 2% are treated pharmacologically for it.(2) But the landscape for obesity treatment and medication is rapidly evolving, with developments centered around one particular class of medications: glucagon-like-peptide-1s, or GLP-1s. GLP-1s were originally created for diabetes, but are now indicated for obesity treatment. 

However, there are only about 5,000 obesity medicine-certified physicians in the US, who are not  not geographically distributed, leaving many populations that are most affected by obesity without access to care.(3) Through the creation of a digital program available in all 50 states and DC, Calibrate addresses this critical unmet need and improves access by treating obesity and metabolic health at scale.

Calibrate’s Approach to Obesity Treatment

Calibrate treats the root cause biology of obesity by combining GLP-1 receptor agonist medications (GLP-1s) and intensive lifestyle intervention (ILI) to address how people eat, sleep, move, and manage their emotional health. GLP-1 medications have gotten significant press recently as new therapeutics are becoming increasingly effective. However, medication alone will not solve the obesity epidemic. Calibrate is setting a new standard of care for obesity by combining medication with our proprietary intensive lifestyle intervention to drive weight loss and metabolic health improvements and put people back in control of their health with sustained success after medication. Publishing Calibrate program results is a critical step toward our mission to change the way the world treats weight.

The Analysis

To understand how these medications and our unique ILI work through a digital platform providing medical management, 1:1 coaching, and digital treatment, Calibrate analyzed health data for individuals who had reached 12 months in the core program and for a smaller subset of all members who continued to 18 months. Members’ weights were recorded in our app through a cellular scale, and metabolic labs were collected at the start of the program and again at 12 months. Members completed questionnaires to self-report changes in food, sleep, exercise, and emotional health throughout the program. 

The Results

Results from the study cohort of 1,175 members showed that Calibrate’s standard of care, combining medication with our unique ILI, leads to robust and sustained weight loss as well as improvements to metabolic health markers and positive self-reported health outcomes.

At one year, average weight loss for members who completed the Calibrate program was 14.8%, and those who continued into a second program year saw average weight loss of 15.8% at 15 months and 16.5% at 18 months. These results are groundbreaking in the real world. For context, the clinical trial research for the GLP-1 medications that >95% of our members took, typically show weight loss around 7-8%. 

Beyond weight loss, we also saw other important health and habit improvements:

• Waist circumference decreased on average by 5.3 inches (-12.4% reduction). Importantly, as waist circumference is related to the harmful visceral-fat stored in the abdomen, only 4% of people started with a normal waist circumference, and 37% were normal at 12 months.
• For members starting with diabetes or pre-diabetes, 84% had improvements in their disease status at 12 mo (meaning a categorical shift from pre-diabetes to normal or from diabetes to normal or pre-diabetes). In a world where diabetes rates are rapidly increasing––diabetes incidence has grown from 6.4% in 2004 to an estimated 10.5% currently––being able to return people to healthy levels is incredibly impactful.(4,5) 
• We also saw improvements in all of the other metabolic markers we evaluated, including waist circumference, cholesterol (HDL, LDL, Triglycerides), liver function tests, insulin, and inflammation (as measured by hs-CRP). Positive changes were seen in 50– >70% of members, indicative of metabolic health improvements. 
• In self-reported outcomes, members demonstrated improvements to overall health, food habits, exercise, sleep habits, and exercise. 70% of members chose to re-enroll in Calibrate’s Year 2 Masters program.
• Medications were well-tolerated. Only 2% of members dropped out of the program due to adverse effects, a rate that is lower than the placebo group in most GLP-1 trials. (For context, the most recent GLP-1 clinical trials typically show 6-7% drop out in the medication treatment arms and 3% drop out in the placebo arms for side effects.) 

Why These Results Matter

As the only company in the industry with a commitment to regularly publishing clinically-validated results, we are setting the standard of care in obesity treatment. Ongoing iteration will allow us to expand upon real-world data capture and continue to improve our ability to evaluate and report upon health, behavior change, and satisfaction outcomes. Importantly, our commitment to research keeps us at the cutting edge of what is most effective to drive results in people’s lives. Data-driven protocols derived from these efforts will allow us to continue to build and develop enhanced programming.  

Providing access to best-in-class treatment is central to Calibrate’s mission. Prior to Calibrate, obesity treatment was primarily only available in academic settings and did not involve the comprehensive lifestyle and behavioral change elements central to Calibrate’s standard of care. More than 25,000 members have joined Calibrate to date, and we’re working across policy, medical, employer, educational and outreach avenues to remove barriers to care. 

Finally, the potential impact of this work extends well beyond obesity. Calibrate’s program treats obesity as part of the cardiometabolic health spectrum, reducing the risk of cardiovascular disease, diabetes, fatty liver disease, and other weight-related conditions. Longitudinal data will enable us to demonstrate the power of our results over time and will change the way the world treats weight. 

Results based on “Real-World Outcomes Using Medication and Intensive Lifestyle Intervention to Treat Obesity at Scale”, authored by Kim Boyd MD, Kaelen L. Medeiros MS, Daniel Kramer, and Isabelle Kenyon of Calibrate and Donna Ryan, MD, a paid advisor and member of the Calibrate Clinical Advisory Board. 

References: 

1. Adult Obesity Facts. Overweight & Obesity. CDC.

2. Saxon DR, Iwamoto SJ, Mettenbrink CJ, McCormick E, Arterburn D, Daley MF, Oshiro CE, Koebnick C, Horberg M, Young DR, Bessesen DH. Antiobesity Medication Use in 2.2 Million Adults Across Eight Large Health Care Organizations: 2009-2015. Obesity (Silver Spring). 2019 Dec;27(12):1975-1981. doi: 10.1002/oby.22581. Epub 2019 Oct 11. PMID: 31603630; PMCID: PMC6868321.

3. More than 5,200 Physicians are Now Board Certified in Obesity Medicine. Obesity Action Coalition, April 13, 2021. 

4. National and State Diabetes Trends. CDC.

5. Diabetes Statistics. Diabetes Research Institute Foundation.