Science

A new era of weight-loss gadgets is here—but for dieters, there’s no easy answer

I felt a special kind of awe, then panic, watching my glucose levels skyrocket for the first time after savoring a cold beer on a hot summer evening. It was a biological push from the fluid right under my skin to inform that the carbohydrate-laden beverage was interfering with my health and efforts to maintain weight.

For years, people with type 1 diabetes have worn a continuous glucose monitor, or CGM, to track blood sugar spikes and make sure they are getting enough insulin. There are small patches with tiny needles for CGM sensors that prick the skin and are usually worn on the abdomen or on the back of the arm.

Now, a wave of tech companies are selling CGMs to the public. This got me curious: would this work for me? what will i learn?

Personalized analytics and meal planning advice linked tools to apps as behavior-changing paths to improved health and athletic performance, consistent energy, and overcoming the dreaded weight-loss-weight-gain cycle once and for all He is going.

For people without diabetes, tracking the glycemic response to a food can help identify which foods increase blood sugar significantly, leading to a subsequent drop in blood sugar and then lethargy. Excess insulin and glucose in the bloodstream can also prompt the body to store excess sugar, which can lead to weight gain.

glucose monitor
The illustration shows a picture of a Dexcom G6 glucose monitor with an image of a glucose reading spike on top.

Eric Harklerod/KHN Illustration; Hannah Norman/KHN; Screenshot of Level app; unsplash


The new-age, health-monitoring ecosystem extends far beyond CGMs, leaving traditional step counters in the dust. A tracker in the form of a sleek, titanium ring made by Ultrahuman monitors movement and sleep—and can be combined with a glucose-monitoring patch. Hoop’s wearable technology, which tracks respiratory rate, blood oxygen and other health metrics, can be embedded in sports bras. Another tool, Lumen, analyzes breath to determine whether a user is burning carbs or fat.

The market for this technology is huge, from Olympic athletes to office workers who want to escape the post-lunch silence. The nation has long been known for what is often referred to as an obesity epidemic. According to Gallup polls, from 2017 to 2021, an average of 26% of Americans said they were “seriously trying to lose weight,” and more than half said they wanted to. and approximately 96 million American adults have prediabetesTheir risk of developing chronic diseases such as type 2 diabetes and heart disease increase, according to the Centers for Disease Control and Prevention. Prediabetes affects people who are both lean and overweight, although obesity increases the risk of diabetes.

Investors are taking note. About $3.5 billion was invested in US weight loss digital health startups from 2020 to the first half of 2022, according to an analysis by KHN’s venture fund Rock Health. CGM startups Level, NutriSense, Cynos and Jan have collectively raised more than $140 million in funding, according to CrunchBase, the company’s funding database.

There is a lot of hype about all the data they deliver.

Advertisements online and in podcasts often feature active 20-somethings. They promise unique insights into how individual bodies react to food, exercise, and sleep in real time, by paying attention to metabolic health and how well users keep their glucose levels up. “We’re losing weight by giving voice to every body,” says Cynos, a CGM-based company that shares a promo for Lumen: “You hold the secret to sustainable weight loss in your lungs.”

Lumen devices and smartphone monitors
Lumen analyzes a user’s breath to determine whether they are burning carbs or fat.

lumen


But even as people in the field have seen “significant” results from incorporating these devices into weight loss programs, they acknowledge that no single approach seems to be able to do it all. For example, chiropractic doctor Eric Kusher, who runs an intensive weight loss program at Compass Fat Loss, said he still relies on the human element, falling back on his staff’s dietary advice, not apps. On the food guidance provided.

The reality layer is also important, said Dr Nirav Shah, a senior scholar at Stanford University’s Clinical Excellence Research Center. “If you’re a troubled mom trying to take care of three kids and work a job, you won’t have time to supervise and make the perfect green shake,” he said. “You’re going to buy dollar food because it’s easier and cheaper for your kids—and then you’re going to eat what they don’t eat.”

To lose weight and reduce inflammation, Sarah Schacht, a 42-year-old government innovation consultant from Seattle, has tried all kinds of health techniques, including Levels and Lumens. The generalized “eat less, move more” – flawed advice for many – was not working for her. The Levels app lets the user log meals, exercise and other notable events; Combines information with CGM data; And then provides insight and advice on how users can promote gentler glucose curves. Since starting the level a year and a half ago, she’s lost 5 pounds, her weight has stabilized, and inflammatory responses have subsided. But her body hasn’t changed dramatically, she said.

“I think some of the success stories I’ve seen are people who have radically changed their bodies, spending a lot of time on their eating strategy,” Schacht said. “Not everyone has that mental capacity, time, or budget.”

These devices are not covered by insurance, so, with related subscriptions for data, the cost can be hundreds of dollars annually. There has also been little research on the effectiveness of CGMs in improving the health of people without diabetes, let alone weight loss. Without concrete results, many health care providers are skeptical. Some experts also worry that the constant stream of data could lead to disordered eating.

Woman uses glucose sensor and Freestyle Libre scanner
File photo of a young woman equipped with a glucose sensor and a Freestyle Libre scanner that measures blood sugar levels.

BSIP / Universal Image Group via Getty Images


Co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Boston, Dr. Carolyn Apovian said she doesn’t see the use of expensive CGMs for someone who doesn’t have diabetes, especially new weight loss drugs are accessible. Those drugs, of course, would also carry a hefty price tag.

“It’s hard work losing 10 pounds,” Apovian said. “A CGM will wipe out your money so you can’t join the gym.”

Of those who have insulin resistance and metabolic disease, the majority are low-income and a minority who can’t afford CGMs, said Logan Delgado, co-owner of BioCoach. BioCoach has FDA approval for a glucose and ketone meter, which checks glucose levels and tests for ketones in the blood — a sign that the body is burning fat for energy. Its more traditional finger-prick technology keeps subscription prices as low as $30 a month, while still letting people without diabetes know about their metabolic health, though not with continuous data. The company has amassed a large number of followers on TikTok, where Delgado and others raise awareness about Chinese foods and diabetes.

CGM startups typically offer one of two CGMs: Abbott’s FreeStyle Libre, which is cheaper and requires manual scan of the sensor by smartphone, or the Bluetooth-connected Dexcom G6, which automatically updates to the smartphone. it happens. Monitors are provided via “off-label” prescription to people without diabetes because the FDA has not yet approved the devices for the general population.

CGMs are available over-the-counter in Europe, so companies are betting that the FDA will approve them to be available on drugstore shelves in the US, reducing the cost of sensors, which can cost hundreds of dollars.

But it already said in January that it could use artificial intelligence to predict a person’s glucose levels after a user wears a CGM for two weeks. The algorithm, backed by published research and a library of food nutrition data, can estimate a person’s glucose response to thousands of foods before a user decides what to eat after eating. This reduces costs, essentially creating a virtual CGM, said Jan’s CEO Nushin Hashmi. The company is rolling out a new version of its app this fall.

Across the board, startups are largely working through kinks, with some still conducting research to back up their marketing claims and taking different approaches to using the technology. A common theme for startups, however, is going straight-to-consumer first — for those who can afford the concept — eventually seeking coverage from insurers, said Bill Evans, founder and general partner of Rock Health Capital. before doing.

Companies are trying to add novel twists to how they use data to reach health and weight loss goals, each with libraries of informative blogs, lessons and activities. They range in cost from hundreds of dollars to over a thousand, with fees covering the cost of hardware, subscriptions to wraparound services, and in some cases nutritionist support. Companies are relying on the idea that customers will sign on for a longer period.

Taking a more wraparound approach, NutriSense has leaned heavily into building an 80-person nutrition team that works closely with customers, according to Kara Collier, the company’s vice president of health.

Cyanos, which focuses on weight loss, uses artificial intelligence to set “weight loss limits” for customers based on their normal glucose ranges and fitness levels.

Curiously, this reporter stuck a CGM on the back of his arm for 10 days and signed up for the Levels app. At first, the metrics were jarring. As a person without diabetes, I had never calculated my glucose levels before.

Then I began to recognize patterns that made sense: Drinking beer always raised my glucose, but a bagel kept my blood sugar relatively stable after a long morning walk. However, avocado toast or eggs were better choices for breakfast. And the salad with chickpeas, tomatoes, and turkey for lunch earned top marks.

Digesting the accompanying data for each meal certainly made it difficult for me to think about what I ate and when I exercised. But it also felt like a lot of extra homework.


KHN (Kaiser Health News) is a national newsroom that conducts in-depth journalism about health issues. Along with policy analysis and polling, KHN is one of three major operational programs. kff (Kaiser Family Foundation). KFF is a thriving non-profit organization that provides information on health issues to the nation.

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