Optimizing Weight Loss Maintenance: Can Continuous Glucose Monitoring Play a Role (OWL-CGM)? A Randomized Controlled...

Maintenance of weight loss is a major challenge. Continuous glucose monitoring (CGM) could provide biofeedback to support lifestyle changes to facilitate weight maintenance. This randomised controlled trial evaluated the feasibility of incorporating CGM into a personalised, dietitian-led, weight loss maintenance programme (PWM), and whether CGM use led to greater improvements in dietary intake, physical activity, body weight, body composition, and cardiometabolic risk biomarkers over 24 weeks.

Adults who lost >5 kg bodyweight in the past six months were eligible. Of 131 individuals who expressed interest, 99 met eligibility criteria. Forty-nine participants (17 men, 32 women) consented and were randomised to either PWM (n = 25) or PWM/CGM (n = 24) groups. Average recruitment rate was five participants/month. All participants received five one-to-one personalised dietitian consultations in weeks 1, 2, 4, 8 and 12; the PWM/CGM group also received a CGM for the 24-week intervention period and education on its use to support diet and physical activity behaviours.

19 PWM and 22 PWM/CGM participants completed the study (83.7% of randomised participants). All completers attended all dietitian consultations, and PWM/CGM participants wore their CGMs on 92.6% of intervention days. In completers, weight loss at 24-weeks was greater for PWM/CGM than PWM (-2.7 ± 1.1 kg vs +0.5 ± 0.8 kg, p = 0.032). This difference remained significant in an intention-to-treat sensitivity analysis (-2.5 ± 1.0 kg vs +0.4 ± 0.6 kg, p = 0.012). Change in energy intake from baseline to 24-weeks was greater in PWM/CGM than PWM (-235.0 ± 123.0 kcal.day^-1 vs +23.3 ± 201.6 kcal.day^-1, p = 0.007). There were no differences in changes in physical activity or cardiometabolic risk biomarkers except triglycerides between groups.

These findings indicate that CGM is a feasible addition to an intensive weight loss maintenance programme and support a future fully-powered randomised controlled trial to determine long-term effectiveness.

gov (NCT05890209).