{
  "abstract": "BackgroundIncretin-based obesity medications (IOMs) produce substantial weight loss, but the incremental benefit of structured nutritional therapy when integrated with pharmacotherapy remains unclear.\n\nObjectivesTo compare 12-month weight-loss outcomes between individualized carbohydrate-reduced nutritional therapy combined with IOMs (VINT+IOM) and IOM-based care without structured nutritional therapy (IOM only).\n\nMethodsThis retrospective cohort study evaluated 4,269 adults enrolled in a comprehensive telemedicine obesity care program (VINT+IOM, n=1,658; IOM only, n=2,611). Both pathways included clinician-guided medication management and behavioral coaching. The primary analysis focused on GLP-1-naive participants receiving a single medication ingredient (semaglutide or tirzepatide). Adjusted weight changes were estimated using longitudinal linear mixed-effects models. Additional analyses evaluated weight-loss responders, prior GLP-1 exposure, and medication utilization.\n\nResultsAmong GLP-1-naive semaglutide users, adjusted 12-month weight loss was greater with VINT+IOM than IOM only (30.7 vs. 24.1 lb; P=0.01), with corresponding observed weight loss of 13.3% versus 11.1%. Among tirzepatide users, adjusted weight loss was 45.9 versus 34.4 lb (P=0.003), with observed reductions of 19.7% versus 15.6%, respectively. Weight-loss responder rates consistently favored VINT+IOM. In the overall cohort (GLP-1 naive, prior users and all other treatment trajectories), adjusted weight loss was 29.4 versus 21.5 lb (P<0.001), with observed reductions of 12.7% versus 9.6%. Greater weight loss with VINT+IOM was also observed among participants with prior GLP-1 exposure. Weight loss continued between 6 and 12 months in both pathways. Medication coverage was high, with approximately 80% of participants achieving proportion of days covered [≥]80% in both pathways.\n\nConclusionsIntegrating individualized carbohydrate-reduced nutritional therapy with IOM-based care was associated with greater 12-month weight loss than IOM-based care without structured nutritional therapy. These real-world findings support further evaluation of individualized nutritional approaches as an adjunct to incretin-based obesity pharmacotherapy.",
  "abstract_shown": true,
  "affiliations": [
    "Virta"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "S. Athinarayanan"
    },
    {
      "name": "A. R. Zoller"
    },
    {
      "name": "K. E. Bergethon"
    },
    {
      "name": "A. M. Goss"
    },
    {
      "name": "B. A. Gower"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7h1tm8z14eghp.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.09.26365158",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.09.26365158v1.full",
  "id": "7h1tm8z14eghp",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.09.26365158v1",
  "language": null,
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "nutrition"
    ],
    [
      "openalex",
      "2736|Pharmacology and Obesity Treatment"
    ]
  ],
  "openalex": "W7221701108",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.09.26365158v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-09",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7h1tm8z14eghp.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:45Z",
      "native_id": "10.64898/2026.10.09.26365158",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.09.26365158v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:nutrition",
      "subfield": "nutrition"
    }
  ],
  "title": "Real-World Twelve-Month Weight Loss Outcomes in a Comprehensive Obesity Care Program Utilizing Individualized Nutrition Therapy and Incretin-Based Obesity Medications",
  "title_text": "Real-World Twelve-Month Weight Loss Outcomes in a Comprehensive Obesity Care Program Utilizing Individualized Nutrition Therapy and Incretin-Based Obesity Medications",
  "type": "preprint",
  "updated_at": "2026-10-30T12:20:45Z",
  "url": "https://research.draconitic.com/paper/7h1tm8z14eghp",
  "venue": "medRxiv",
  "versions": []
}