TY  - JOUR
AU  - Zakaria, Hala
AU  - Jabri, Hadoun
AU  - Alshehhi, Sheikha
AU  - Caccelli, Milena
AU  - Debs, Joelle
AU  - Said, Yousef
AU  - Kattan, Joudy
AU  - Almarzooqi, Noah
AU  - Hashemi, Ali
AU  - Almarzooqi, Ihsan
PY  - 2025
DA  - 2025/3/27
TI  - Glucagon-Like Peptide-1 Receptor Agonists Combined With Personalized Digital Health Care for the Treatment of Metabolic Syndrome in Adults With Obesity: Retrospective Observational Study
JO  - Interact J Med Res
SP  - e63079
VL  - 14
KW  - metabolic syndrome
KW  - obesity
KW  - GLP-1 medications
KW  - hybrid model of care
KW  - digital health
KW  - effectiveness
KW  - digital engagement
KW  - hybrid care
KW  - adult
KW  - cardiovascular disease
KW  - type 2 diabetes
KW  - insulin resistance
KW  - efficacy
KW  - behavioral change
KW  - obese
KW  - zone health
KW  - weight loss
KW  - monitoring
KW  - tirzepatide
KW  - semaglutide
KW  - treatment
KW  - medication
KW  - telehealth
KW  - health informatics
KW  - glucagon-like peptide-1
AB  - Background: Metabolic syndrome (MetS) represents a complex and multifaceted health condition characterized by a clustering of interconnected metabolic abnormalities, including central obesity, insulin resistance, dyslipidemia, and hypertension. Effective management of MetS is crucial for reducing the risk of cardiovascular diseases and type 2 diabetes. Objective: This study aimed to assess the effectiveness of combining glucagon-like peptide-1 (GLP-1) and dual gastric inhibitory polypeptide (GIP)/GLP-1 agonists with a continuous, digitally delivered behavioral change model by an integrated care team, in treating MetS among individuals with obesity. Methods: The 6-month Zone.Health (meta[bolic]) weight loss program involved 51 participants (mean age 45, SD 10 years; mean BMI 35, SD 5 kg/m²), categorized by gender, and treated with either tirzepatide or semaglutide. Participants received continuous support via a digital health platform, which facilitated real time monitoring and personalized feedback from an integrated care team. Engagement levels with the digital platform, measured by the frequency of inbound interactions, were tracked and analyzed in relation to health outcomes. Results: Tirzepatide reduced waist circumference (WC) by −18.08 cm, compared with −13.04 cm with semaglutide (P<.001). Triglycerides decreased significantly with both drugs, with tirzepatide showing a reduction of −64.42 mg/dL and semaglutide −70.70 mg/dL (P<.001). Tirzepatide generally showed more pronounced improvements in fasting glucose, blood pressure (BP), low-density lipoprotein, and total cholesterol compared with semaglutide. Higher engagement with the digital health platform showed significant difference among the 3 groups; the group with the highest level of app-based interactions (≥25 interactions) had the greatest WC reduction (mean −19.04, SD 7.40 cm) compared with those with ≤15 interactions (mean −9.60, SD 5.10 cm; P=.002). Similarly, triglycerides showed the greatest reduction in the group with ≥25 interactions (mean −108.56, SD 77.06 mg/dL) compared with those with ≤15 interactions (mean −44.49, SD 50.85 mg/dL; P=.02). This group also exhibited the largest reduction in diastolic BP (mean −10.33, SD 7.40 mm Hg) compared with those with ≤15 interactions (mean −0.83, SD 7.83 mm Hg; P=.004), and the most substantial decrease in fasting glucose levels (mean −18.60, SD 10.82 mg/dL) compared with those with ≤15 interactions (mean −2.49, SD 27.54 mg/dL; P=.02). Participants in the highest quartile of digital engagement had a 60% greater likelihood of MetS reversal compared with those in the lowest quartile. Conclusions: This study shows that combining GLP-1 and dual GIP/GLP-1 agonists with a digital behavioral change model significantly improves MetS markers in individuals with obesity. Tirzepatide proved more effective than semaglutide, leading to greater reductions in WC and triglyceride levels, along with better improvements in fasting glucose, BP, and lipid profiles. Higher app-based engagement was linked to better health outcomes, with participants in the highest engagement group having a 60% greater likelihood of treating MetS compared with those with the lowest engagement. 
SN  - 1929-073X
UR  - https://www.i-jmr.org/2025/1/e63079
UR  - https://doi.org/10.2196/63079
DO  - 10.2196/63079
ID  - info:doi/10.2196/63079
ER  -