Intermittently Scanned Continuous Glucose Monitoring Enhances Weight Loss and Adherence in Women with Obesity: A Randomized Controlled Trial

Abstract

Background:

Lifestyle interventions focusing on diet and physical activity often fail to achieve sustained weight loss, primarily due to low adherence. Intermittently scanned continuous glucose monitoring (isCGM) may serve as a behavioral feedback tool, enhancing motivation and compliance in individuals with obesity.

Objectives:

To evaluate whether incorporating isCGM into a structured lifestyle intervention improves weight loss, body composition, and metabolic outcomes in women living with obesity.

Methods:

In this 12-week randomized controlled trial, 35 women with overweight or obesity (body mass index [BMI] > 25 kg/m²) were assigned to either an intervention group (n = 17) using isCGM at baseline, mid-intervention, and study end, or a control group (n = 18) using isCGM only at baseline and end. Both groups participated in supervised exercise (3 sessions/week) and received identical dietary counseling. Primary outcomes included changes in body weight and BMI; secondary outcomes comprised body composition, adherence to dietary recommendations, and CGM metrics (time in range [TIR], time below range [TBR], coefficient of variation, HbA1c).

Results:

Compared with controls, the intervention group achieved significantly greater reductions in body weight (−5.5 ± 2.3 kg vs. −0.2 ± 1.8 kg, P < 0.001), BMI (−1.9 ± 0.6 vs. −0.1 ± 0.4 kg/m², P < 0.001), waist-to-height ratio, body fat, and visceral fat, alongside increased muscle mass and improved dietary adherence (P < 0.05). Clinically meaningful weight loss (≥3% BMI and body fat reduction) occurred in 35% of the intervention group versus 0% of controls. TIR improved modestly in the intervention group (P = 0.03).

Conclusions:

Integrating isCGM into lifestyle interventions enhances adherence and supports clinically significant improvements in body composition and glycemic control among women with obesity. Larger, longer-term studies are warranted to confirm these findings.