In 2002, a landmark paper published in the New England Journal of Medicine described the results of the Diabetes Prevention Program (DPP), a large 27-center study involving more than 3,000 patients. The DPP showed that modest weight loss (5-7% of body weight) through dietary changes and increased physical activity reduced the risk of developing type 2 diabetes by 58 percent. The only problem: it’s difficult, and expensive, to run an intensive lifestyle modification program, especially for the estimated one in three US adults who have prediabetes.
That’s the problem that digital health start-up Omada Health set out to solve. Almost one decade after that NEJM paper, Omada is launching the first-ever online diabetes prevention program for the general public: Prevent. It essentially translates the DPP into an online, 16-week course that leverages digital tracking tools (e.g. weight scales, pedometers), personalized coaching, social support, and an interactive web-based curriculum to motivate healthy exercise and eating behaviors. When people sign up for Prevent they are matched into small groups in a private online environment, “based on age, body mass index, and location.” They are then sent a Path16 wireless scale that requires virtually no set-up and automatically syncs to Prevent, allowing them to transmit daily weigh-ins to their private personal profiles. Over the following 16 weeks they go through a behavior-change curriculum and receive support from peers in their group and a health coach.
But how does this web-based counterpart compare to the DPP? The results are promising: the 230 Prevent users in Omada’s pilot study experienced an average weight loss of 13.7 pounds (6.4%) in 16 weeks. That’s right there in the 5-7% goal laid out by the DPP trial.
We caught up with Omada’s co-founder and CEO, Sean Duffy, to discuss the Prevent launch. Full disclosure: Sean is a Medgadget editor who has been on leave to work full-time on Omada. He walked us through a demo of Prevent and answered a few of our questions:
Shiv Gaglani, Medgadget: What has most surprised you during the development of Omada’s first product, Prevent?
Sean Duffy: I was surprised by how organically the social experience evolved inside of our pilot groups. People quickly got to know and trust each other and their Prevent coaches. We had a number of groups where people started meeting up in person to exercise together, and people were exceptionally supportive during times of stress. In many of the groups, the tenor of the conversation was just as much about daily living as it was about lifestyle change and weight loss.
Medgadget: Can an independent consumer sign up for Prevent, say as a New Year’s Resolution?
Duffy: Yes. For the first time ever, individual consumers can sign up for Prevent [4 month program, $120/month]. We have a CDC-validated risk-screening survey that helps people understand their diabetes risk, and we’ll soon sell HbA1c testing kits directly to consumers (for a very low cost). People who find out they have prediabetes or who are at risk for diabetes will be able to sign up for Prevent on their own.
Medgadget: What are some major milestones for the upcoming year?
Duffy: We’ve spent the last year ironing out all the kinks in the workflow involved in bringing people through an online, 16-week program in small groups. Now that we’ve tested the model with hundreds of people, during this upcoming year, we’re going to really push promotion and sales, and work to bring Prevent to as many people with prediabetes as possible. We’ll also launch our mobile apps and begin a few research efforts. We may even launch a few other digital health products!
Medgadget: The weight loss achieved in 16 weeks is impressive – are there any mechanisms to help patients maintain their weight loss?
Duffy: After participants graduate from Prevent’s core program, they move into our Sustain program. We create alumni pools, nominate group coordinators that serve as social liaisons to the alumni pools, and we have all sorts of other mechanisms to keep people engaged. We’re not ready to report our 6-month weight readings, but they’re quite encouraging. It appears that people are continuing to lose weight. To put this in context, we’re not proposing that we, or anyone else for that matter, can create a magic weight-loss program where people don’t ever regain weight. We simply need to have an exceptional program where the re-gain trajectory is approximately the same as the original DPP trial. In the original DPP study, people in the lifestyle arm did regain weight, but it was quite slow, and even 10-years out, there is a spread between the intervention arm and the control arm. The DPP is a high bar, and we have to give our participants everything they need to be successful and maintain clinically-meaningful results.
To learn more about Prevent, check out their newly launched website…