Today, I review, link to, and excerpt from Frontiers In Nutrition‘s TOWARD, a metabolic health intervention, demonstrates robust 1-year weight loss and cost-savings through deprescription [PubMed Abstract] [Full-Text HTML] [Full-Text PDF]. Front Nutr. 2025 Feb 14:12:1548609. doi: 10.3389/fnut.2025.1548609. eCollection 2025.
All that follows is from the above resource.
Abstract
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 6-month 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.
Results
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. Annualized cost savings from the TOWARD approach were approximately -$1700 per patient, as compared to an annualized cost burden of roughly +$13000 per patient for a GLP-1 receptor agonist.
Conclusion
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: GLP1, diabetes, ketogenic, obesity, telemedicine, therapeutic carbohydrate reduction, carnivore diet, intermittent fasting Graphical Abstract
