Feasibility of Digital Dietary Assessment (FIDGET) Study
Research type
Research Study
Full title
A feasibility study to determine the most appropriate digital dietary assessment tool in patients with obesity initiating GLP-1 receptor agonist treatment
IRAS ID
347758
Contact name
Rachel Gibson
Contact email
Sponsor organisation
King's College London
Clinicaltrials.gov Identifier
347758, IRAS Project ID:
Duration of Study in the UK
0 years, 6 months, 30 days
Research summary
GLP-1 receptor agonists are valuable group of therapeutic medication options in the management of type 2 diabetes and obesity. The mechanism of action of these agents is thought to include a reduction in appetite and increase in levels of fullness. Semaglutide (Wegovy) is a weekly injectable GLP-1 medication that has recently been approved by the National Institute for Health and Care Excellence (NICE) for use in the NHS as a weight management intervention for up to 24 months in those with obesity and related illnesses. Clinical trials have shown up to 15% reduction in body weight at one year when Wegovy is used in conjunction with diet and physical activity support. The long-term impacts on nutritional status and weight regain post treatment are currently unknown. While nationwide audits for clinical outcomes and safety are in place, behavioural factors that are explicitly linked to GLP-1 mechanisms, especially dietary intake and patterns including food frequency, are not routinely reported. Prescribing of Wegovy is due to start at Guy’s and St Thomas’ NHS Trust (GSTT) in April/May 2024. The current Tier 3 and 4 weight management service waiting list at GSTT is now exceeding 2,000 patients, providing a rich but currently untapped patient cohort with diverse ethnic and cultural representation; approx. 47%, 20%, 17% and 16% of patients in the service are of White, Black African, Black Caribbean and Other heritages respectively. Electronic health records are now central to NHS care delivery and potentially promise to improve the safety and efficiency of healthcare services. EPIC is an electronic health record that was implemented in GSTT in late 2023, providing a novel opportunity to establish a digital cohort of patients who are commencing Wegovy (for those living with obesity with conditions that may include type 2 diabetes) and monitor key clinical behavioural factors as they progress through the new care pathway. While body weight, blood test results and standard questionnaires are straightforward to capture and report electronically, dietary intake is more challenging. For example, foods and beverage preference and intake have high variability within and between population groups, and this intake data must be translated to individual nutrient intake profiles. Time and frequency of eating are important to capture to enable future personalised dietary interventions. Traditionally handwritten diet records or verbal recalls are used in clinic. However, these methods are resource intensive and not readily transferable to electronic health records and centralised collection. There are several validated digital tools available that that could enable the capture of high-quality dietary intake data with new levels of precision, scale, and efficiency, but the feasibility of their routine integration into real-world practice in a patient cohort is yet to be explored. This project will assess three different digital platforms for recording dietary intake to determine their feasibility and acceptability to patients and clinicians. Outcomes from this project will inform a future NIHR (Programme Grant for Applied Care) application to establish a GSTT GLP-1 longitudinal cohort that evaluates long-term clinical and behavioural health outcomes. This will uncover new knowledge of how GLP-1 treatment changes dietary intakes over time, the risk of nutrient deficiencies and inform post-pharmacological treatment models of care that are patient-centred.
REC name
HSC REC A
REC reference
25/NI/0086
Date of REC Opinion
2 Jul 2025
REC opinion
Further Information Favourable Opinion