Engagement With AI-CGM Platform Boosts Weight Loss: Stephanie Kim, MD, MPH

A real-world study published in Journal of Diabetes Science and Technology found that adults with obesity lost weight nearly 3 times faster during periods of active engagement with the Signos System—an artificial intelligence (AI)- and continuous glucose monitoring (CGM)–integrated digital health platform—compared with periods of nonengagement (1.17% vs 0.44% per week). Highly engaged participants with class III obesity achieved more than 7% total body weight loss at 6 months, surpassing the 5% threshold widely recognized as clinically meaningful for cardiometabolic risk reduction.

In an email to The American Journal of Managed Care^® (AJMC^®), Stephanie Kim, MD, MPH, principal investigator at Signos; assistant professor of clinical practice in the Department of Metabolism, Endocrinology & Nutrition; and medical director of the Diabetes Institute Clinical Research Unit at the University of Washington, spoke about what the findings mean for obesity care, how the within-subject study design strengthens the case for engagement as an active driver of outcomes, and where a platform like Signos fits alongside pharmacotherapy options such as glucagon-like peptide-1 (GLP-1) receptor agonists.

This interview was lightly edited for clarity.

AJMC: Can you explain the key findings of this study and why the relationship between engagement and weight loss is significant for the obesity care field?

Kim: The study found that adults with obesity lost weight nearly 3 times faster during periods when they actively engaged with the Signos System: 1.17% vs 0.44% per week. At 6 months, participants with higher engagement lost approximately 6% of their body weight, while highly engaged participants with class III obesity achieved over 7% weight loss.

This is significant because it suggests that engagement is not simply an app-usage statistic; it may be an important and modifiable part of effective obesity treatment. By delivering personalized, real-time feedback around food, activity, and glucose responses, Signos helps people turn their own metabolic data into healthier day-to-day decisions, and it does so at a scale that traditional, in-person programs can't easily match

AJMC: The data show that weight loss during engaged periods was nearly 3 times greater than during nonengaged periods (1.17% vs 0.44% per week). What does this within-subject comparison tell us that a traditional between-group study design couldn't?

Kim: The within-subject design allowed each participant to serve as their own comparison. That helps account for characteristics—such as genetics, baseline body mass index (BMI), sex, and many aspects of personality or socioeconomic background—that can make highly engaged and less-engaged users fundamentally different in a traditional between-group analysis.

Most importantly, the results show that the same individual tended to lose weight faster when engaged with the Signos app than when less engaged or not engaged. That provides a particularly compelling real-world signal that engagement may be an active contributor to success, rather than simply a marker of people who were already more motivated or more likely to lose weight.

AJMC: One notable finding is that timing of engagement—early vs late in the platform's use—didn't significantly affect weight loss outcomes. How does this challenge assumptions from prior digital health literature, and what does it suggest about how clinicians might counsel patients who struggle with early adherence?

Kim: Prior digital health literature has often emphasized that early engagement is critical to long-term success. In our study, however, weight loss during periods of active engagement was remarkably similar among early and late engagers at 1.18% vs 1.12% per week, suggesting that the benefits of engagement are not confined to a narrow early window.

That is a very encouraging message for both clinicians and patients: a slow start does not mean the opportunity has been lost. Clinicians can normalize lapses, encourage patients to re-engage, and reinforce that meaningful engagement at any point may help generate progress. Signos appears to provide multiple opportunities for individuals to re-engage and achieve successful outcomes over time.

Reference

Grossi G. AI-CGM platform engagement linked to clinically meaningful weight loss. AJMC. June 23, 2026. Accessed June 23, 2026. https://www.ajmc.com/view/ai-cgm-platform-engagement-linked-to-clinically-meaningful-weight-loss