Higher digital platform engagement tied to staying on semaglutide in 48-week study
A single-center study of 191 adults on semaglutide found that those who used a digital assessment platform the most were likeliest to stay on the drug and lose more weight.
A 48-week study of 191 adults with severe obesity found that those who engaged more with a digital assessment platform were more likely to keep taking semaglutide, and that staying on the drug accounted for most of the difference in weight loss [1]. The results were published August 26, 2026, in the Journal of Medical Internet Research [1].
The study followed consecutive adults with a body mass index of at least 40 kg/m² who started semaglutide 2.4 mg per week through a French early-access program at a single center, Montpellier University Hospital [1]. Participants' mean age was 51.7 years, and 31.9% were men [1]. Engagement was measured by how much they used Aviitam, a structured digital platform that collects validated questionnaires: 37 people (19.4%) never used it, 32 (16.8%) used it partially, and 122 (63.9%) completed the questionnaires fully [1]. Using the platform was not required [1].
At 48 weeks, 142 participants (74.3%) were still taking semaglutide, and 124 of them (87.3%) had reached the 2.4 mg weekly dose [1]. Persistence rose step by step with engagement: 59.5% among those who never used the platform, 71.9% among partial users, and 79.5% among those who completed the questionnaires (P=.02) [1]. Each step up in engagement was linked to higher odds of staying on treatment (adjusted odds ratio 1.62, 95% CI 1.05-2.50; P=.03), and the finding held when missing 48-week data were filled in statistically [1].
Weight loss tracked with dose. Mean weight loss was 11.8% across the whole group and 14.6% among those who stayed on treatment [1]. It averaged 3.9% in people who stopped the drug and 15.3% in those at the 2.4 mg dose (P<.001) [1]. A mediation analysis found that 48-week persistence explained about 69% of the link between engagement and weight loss, while the direct effect of engagement was not statistically significant [1].
The paper notes that real-world persistence with this drug class is low — between 32% and 50% at 12 months in administrative data, with fewer than 15% reaching the target dose — so the authors were looking for signals that appear at the start of treatment [1]. Among the 91 persistent participants who completed all seven baseline questionnaires, the Intuitive Eating Scale-2 was the only behavioral measure that survived statistical correction for multiple comparisons (q=0.05) [1].
The study is observational and single-center, so it does not show that using the platform caused people to stay on the drug. Engagement was measured once, at the start, in response to a request that was not enforced [1], and the authors write that low-engagement patients can be identified at initiation and supported, without testing whether any particular type of support works [1]. Whether the pattern would hold for patients in the United States, for people with lower BMIs, or for tirzepatide has not been reported [1]. The platform's cost and how it would be used in routine care were not disclosed [1].
Why it matters for patients
The practical point is that staying on the medication and reaching the full dose mattered as much as the prescription itself. In this cohort, people who stopped semaglutide lost far less weight than those who reached 2.4 mg weekly (3.9% versus 15.3%) [1]. Phase 3 trials of semaglutide 2.4 mg reported 14% to 17% mean weight loss [1] — results that depend on continued treatment, which the paper says fewer than 15% of real-world patients manage at the target dose [1].
The findings also suggest that a patient's early willingness to fill out questionnaires and use a digital tool may flag who is likely to stay on treatment [1]. That is a correlation, not proof that using an app keeps anyone on a drug. The study does not report whether the Aviitam platform is available in the United States [1].
What happens next
No randomized trial testing the platform has been reported. A preprint of the paper first appeared July 4, 2025, and the final version was published August 26, 2026 [1]. Participants were followed for 48 weeks; no longer-term follow-up has been disclosed [1].
Sources
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