Thursday, Dec 14, 2023

Maximizing the Promise of Prescriptions: Why Noom is the Ultimate Companion App for GLP-1s

Dr. Linda AnegawaChief of Medicine, Noom for Work

HLTH

The numbers are clear: 160 million adults in the US want to improve their health and well-being through weight loss. This isn’t a matter of vanity or trying to live up to an impossible ideal: for those who are affected, reducing weight by just 5-10% can improve risk factors and reduce the medical complications of obesity. We now know obesity to be a complex, chronic disease and that its sufferers deserve dedicated and comprehensive care. 


The great news is that there has never been a better time to get support for obesity: In addition to the digital tools that can bring behavior change to our fingertips, my specialty of obesity medicine has been transformed by the new category of medications known as GLP-1s. Early trials have suggested GLP-1s are the most effective anti-obesity medications the medical community has ever had: Studies have shown that weight losses of up to 10-15% are possible. With last week’s approval of Tirzepatide for obesity, the combined power of a GLP-1 with another gut hormone enhancer (GIP) has shown even more promise with losses of up to an astounding 48 pounds or 21% of body weight at 88 weeks vs. placebo in one study. As a result, demand has skyrocketed, with half of US adults who have heard of these weight loss medications interested in trying them. And as GLP-1s are proving beneficial in other disorders including cardiovascular disease, demand is likely to continue to increase.


The Challenge


GLP-1s are an important new tool for weight loss – but as with any tool, they have their limitations. Many patients are challenged by the drugs’ side effects especially at higher doses. In my own clinical practice, I’ve seen some patients have transformative journeys on GLP-1s while others don’t seem to lose weight at all – or even gain more. Even with their power, it is clear that medication alone is not enough: When people stop taking the medication, studies show the weight comes back. 


The answer to maximizing the promise of GLP-1s is to treat patients with a comprehensive approach. This includes a thorough investigation into any hidden causes of weight gain while pairing medication with substantial, long-lasting lifestyle changes. The cornerstones of healthy behaviors like nutrition, exercise, stress management, and sleep are all essential to achieve outcomes. Drugs alone can’t rewire the brain’s craving pathways, or fix insulin resistance. For GLP-1s and other anti-obesity medications to be most effective, it is abundantly clear that they need to be part of a personalized program that reflects the person’s unique biology, lifestyle, and importantly, personal preferences for ongoing engagement and motivation. 


Noom Med is our way of delivering on this mandate – it is our cutting-edge obesity treatment program that combines clinical care and medications with psychology-based behavior change, integrating evidence-based obesity medicine, specially trained clinicians, and our award-winning app that has been proven to work for millions of people.


Why is a Companion App Needed?


GLP-1s are a novel class of pharmaceuticals that demand a specialized companion app. The reason why is so easy to see: current data suggest that many if not most people currently taking a GLP-1 will not be on it forever. And while these drugs are powerful, there are concerns as mentioned above. Gastrointestinal side effects such as nausea, heartburn, and constipation may be severe. And per GLP-1 pharmacology, excess dietary carbohydrates can theoretically promote the insulin-secreting effects of GLP-1s which are not necessarily desirable. In addition, with rapid weight loss on GLP-1s, along with fat loss excess muscle loss is possible. When the drug is removed, a big risk is weight regain without re-building muscle, worsening insulin resistance and leaving the patient with a condition called sarcopenic obesity - potentially worse off than prior to taking the GLP-1. Therefore, it is abundantly clear that lifestyle guidance is necessary to maximize the promise of this medication class. 


Noom’s Edge as a Companion App


At Noom, we know that many people will receive GLP-1s and other anti-obesity medications through their doctor or another source. For those people, Noom’s beloved weight loss program, Noom Weight, is the perfect companion. Noom Weight helps users with all levels of weight loss goals to connect deeply with their own ‘why’ for better health, understand their relationships with food, learn valuable tips to manage stress, track their progress in a variety of ways, stay accountable, and ultimately, lose weight and keep it off through our best-in-class psychological approach. Noom Weight has been used by millions of people across the spectrum of weight acuity because it easily integrates into the lives of our users and produces real results. 


We have a rich history in providing companion app support to users facing serious health issues: Long before Noom Med existed, we partnered with Novo Nordisk to provide companion app support for Saxenda users, with impressive results. We were also the first CDC- approved app-based Diabetes prevention program, which has helped many reduce their risk factors for Diabetes and related comorbidities. 


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Noom’s ability to create lasting lifestyle changes along with metabolic health improvements has been shown in over 50 published peer-reviewed studies. In fact, one study showed that Noom combined with an early GLP-1 produced far better weight loss outcomes than the GLP-1 alone. This was surprising and extremely unusual, as in general the lifestyle arm of anti-obesity medication trials vastly underperforms the drug. I hope this all serves to highlight that while published studies show weight regain off GLP-1s and on lifestyle support only, Noom is far from a business-as-usual lifestyle intervention. Our unique combination of one-to-one human coaching along with AI-powered learnings and design principles drawing from behavioral economics can deliver unmatched efficacy and accountability to each member. In this way we can create ‘lightbulb moments’ - flashes of insight which are powerfully motivating and keep individuals on track to achieve goals.  


Our Mission to Expand Access to Obesity Care


Despite the overwhelming demand for anti-obesity medications in the US, cost is often a barrier to those who need it most. Over one-third of people interested in losing weight say the medications are too costly. Noom helps by providing a pathway to access with on- and off-ramping anchored in proven psychological change methodology. Noom Med clinicians also play a critical role; our clinical evaluation and protocols help risk-stratify patients, and tools have been developed to clearly communicate medical necessity to payors. 


Additionally, we are taking steps to make Noom Med even more accessible to those who can benefit. In 2023 and beyond, we are bringing more US states online, integrating labs and mail-order pharmacies to create a frictionless and end-to-end experience, and partnering with pharmacy benefit managers (PBMs) to establish Noom as a step therapy for prescription coverage. We are also democratizing access to Noom Med by making it available through Noom for Work, our enterprise offering for employees and payors. 


Living the Noom Mission


We are proud to be a leader in digital obesity care support, no matter how you utilize our services: For those who receive GLP-1s through Noom, Noom Med provides holistic support and continuity of care. For those who qualify for GLP-1s elsewhere, Noom is here as a crucial companion to help with adherence to the medication while avoiding muscle loss while building healthy habits to produce better and more sustainable weight loss outcomes.


At Noom, our mission is to empower everyone, everywhere to live a better, healthier life. As a platform that provides crucial services to an at-risk population in need of true support with evidence-based tools, Noom Med’s GLP-1 support tools are the perfect tangible expression of that mission. 


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