Virtual shared medical appointments for obesity and GLP-1 medications: A scalable method for optimizing care delivery

More than half of U.S. adults are eligible for glucagon-like peptide-1 receptor agonist and multi-target incretin (GLP-1) medications. Obesity guidelines recommend multicomponent intensive lifestyle change programs in conjunction with GLP-1 medications; however, there is limited health system infrastructure for this recommended programming.

This was a single site, retrospective cohort study of patients who attended ≥1 virtual shared medical appointment (SMA) in a 4-part series on obesity and GLP-1 medications at the Massachusetts General Hospital (MGH) Healthy Lifestyle Program from October 2024 to September 2025. Included are descriptive assessments of patient engagement, prescriptions, and weight loss among a sub-group of highly engaged patients who attended ≥3 virtual SMAs and began the series below the maximum GLP-1 dose.

Of 54 enrolled patients from 5 cohorts, 33 patients completed ≥1 virtual SMA. The mean (standard deviation, SD) age was 58.0 years (12.8) and 24 (73%) patients were female. In the sub-group of 20 patients who started the series below the maximum GLP-1 dose and attended ≥3 virtual SMAs, 14 (70%) had a dose increase, 1 (5%) had a dose decrease, 4 (20%) had no change in dose, and 1 (5%) switched medications; no patients discontinued GLP-1 medication therapy during the series. There were 17 patients from the sub-group who had weight data in the electronic medical record within 6 months of both the start and end of the series. Pre-and post-series mean (SD) weight was 227 lb (53 lb) and 211 lb (46 lb), respectively; weight decreased by 0-5% for 7 (41%) patients, 6-10% for 6 (35%) patients, and ≥10% for 4 (24%) patients.

The main finding was that attendance in the virtual SMA series, in a sub-group of highly engaged patients who attended ≥3 virtual SMAs and began the series below the maximum GLP-1 dose, was associated with GLP-1 medication dose increases in 70% of participants and all participants remained on GLP-1 medication. Virtual SMAs hold promise for increasing the scalability and efficacy of GLP-1 medication use in conjunction with intensive lifestyle counseling for obesity in primary care.