Diabetes Dialogue: Signos and the Science of Weight Loss

Welcome back to Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!

In this episode, cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss new real-world data evaluating the Signos platform, an FDA-cleared digital weight-loss solution that combines the Dexcom Stelo continuous glucose monitor (CGM) with artificial intelligence–driven behavioral coaching. The platform delivers personalized recommendations based on glucose responses, dietary intake, physical activity, and user-entered data to support lifestyle modification and weight management.

Bellini begins by highlighting the challenges many individuals face in accessing traditional weight-management programs. While in-person and virtual classes can be effective, participation is often limited by time and accessibility. She notes that digital tools such as Signos may offer a scalable alternative by providing continuous support and accountability outside of the clinic setting.

The study included adults aged 18 years and older with obesity (BMI >30 kg/m²) who did not have diabetes. Researchers evaluated whether engagement with the platform was associated with weight-loss outcomes, using a metric called “total meaningful actions per day” to measure how frequently participants interacted with the app and its coaching features.

Among more than 3,000 participants, periods of active engagement were associated with significantly greater weight loss than periods of low or no engagement. Researchers also evaluated a 180-day cohort of 1,147 participants and found a mean total body weight loss of 5.14% over six months. Participants with higher engagement achieved nearly 6% weight loss, compared with approximately 4.3% among those with lower engagement levels. Bellini emphasizes that these results were achieved without the use of weight-loss medications, underscoring the potential impact of personalized behavioral support combined with CGM data.

Isaacs notes that individuals taking anti-obesity medications, including GLP-1 receptor agonists, were excluded from the study. She points out that many patients prefer to pursue weight loss through lifestyle modification rather than long-term pharmacologic therapy, making these findings particularly relevant. At the same time, both hosts suggest that digital coaching platforms could complement GLP-1 therapies by reinforcing nutrition, physical activity, and other healthy behaviors that remain essential for long-term success.

The conversation also addresses cost and accessibility. Isaacs notes that while Dexcom Stelo can be purchased independently at a lower monthly cost, access to the full Signos platform requires a higher subscription fee. Although this may be a barrier for some patients, the hosts compare the expense to other commercial weight-management programs and view it as another option within a broader obesity treatment strategy.

Throughout the discussion, Isaacs and Bellini emphasize the importance of accountability and ongoing engagement in achieving sustainable weight loss. They highlight the platform’s use of AI-generated prompts, reminders, and behavioral challenges designed to keep users engaged and motivated. The episode concludes with optimism about the growing role of digital health technologies in obesity care and the potential for AI-driven, CGM-informed interventions to provide personalized, scalable support for individuals seeking meaningful weight loss.

Editors’ Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others.

References

1. Signos. Latest Study Shows Signos Drives Up to 7% Weight Loss Over 6 Months, Rivaling Real-World GLP-1 Weight Loss. BusinessWire. June 23, 2026. Accessed June 23, 2026. https://www.businesswire.com/news/home/20260623955669/en/Latest-Study-Shows-Signos-Drives-Up-to-7-Weight-Loss-Over-6-Months-Rivaling-Real-World-GLP-1-Weight-Loss