Weight loss in a digital app-based diabetes prevention program powered by artificial intelligence

Abstract

Objective The National Diabetes Prevention Program (DPP) reduces diabetes incidence and associated medical costs but is typically staffing-intensive, limiting scalability. We evaluated an alternative delivery method with 3933 members of a program powered by conversational Artificial Intelligence (AI) called Lark DPP that has full recognition from the Centers for Disease Control and Prevention (CDC). Methods We compared weight loss maintenance at 12 months between two groups: 1) CDC qualifiers who completed ≥4 educational lessons over 9 months (n = 191) and 2) non-qualifiers who did not complete the required CDC lessons but provided weigh-ins at 12 months (n = 223). For a secondary aim, we removed the requirement for a 12-month weight and used logistic regression to investigate predictors of weight nadir in 3148 members. Results CDC qualifiers maintained greater weight loss at 12 months than non-qualifiers (M = 5.3%, SE = .8 vs. M = 3.3%, SE = .8; p = .015), with 40% achieving ≥5%. The weight nadir of 3148 members was 4.2% (SE = .1), with 35% achieving ≥5%. Male sex ( β = .11; P = .009), weeks with ≥2 weigh-ins ( β = .68; P < .0001), and days with an AI-powered coaching exchange ( β = .43; P < .0001) were associated with a greater likelihood of achieving ≥5% weight loss. Conclusions An AI-powered DPP facilitated weight loss and maintenance commensurate with outcomes of other digital and in-person programs not powered by AI. Beyond CDC lesson completion, engaging with AI coaching and frequent weighing increased the likelihood of achieving ≥5% weight loss. An AI-powered program is an effective method to deliver the DPP in a scalable, resource-efficient manner to keep pace with the prediabetes epidemic.

Weight loss and modeled cost savings in a digital diabetes prevention program

“…These behaviors are consistent with previous reports of successful weight‐loss strategies 38,39 . Previous research on the Lark DPP demonstrated that members who weighed ≥2 times per week were significantly more likely to reach ≥5% weight loss 27 . Consistent with that finding, the Achievers in this study averaged 2.5 weigh‐ins per week.…”

“…The Lark DPP is a fully digital lifestyle modification program described in detail elsewhere 27 . Briefly, the program is deployed on an iOS or Android smartphone and is powered by conversational AI.…”

The Effects of Providing a Connected Scale in an App-Based Digital Health Program: Cross-sectional Examination

“…This research was limited by the fact that the provision of the scale was not individually randomized but the result of insurance providers’ choice to provide or not provide scales. In addition, although findings from past research show that both self-weighing and retention are associated with weight loss [ 4 , 5 , 7 ], suggesting that the provision of a scale might also be related to weight loss, this question was outside the scope of this analysis. This preliminary study is timely, given the increasing importance of understanding and attenuating the high rates of attrition in digital health [ 8 - 10 ], and might assist insurance providers to weigh the cost of provisioning a scale to the benefits of increased retention in lifestyle behavioral programs.…”

“…We conducted an observational study of members enrolled in an artificial intelligence (AI)–powered digital health program available via smartphone on a platform called Lark. Information about Lark is published elsewhere [ 5 , 6 ]. We examined differences in self-weighing and retention between members with and without scales provided by their commercial insurance provider.…”

“…Self-monitoring technologies (eg, digital scales) have been shown to improve health outcomes [ 1 , 2 ], such as weight loss, when combined with additional interventions such as coaching [ 3 ]. This may be because they facilitate increased self-weighing, which has been shown to be related to better health outcomes [ 4 , 5 ]. The purpose of this study was to examine whether the provision of a digital body weight scale as part of one’s digital health program was related to increased self-weighing and longer retention.…”