S2845 Lifestyle Medicine RPM Program for Metabolic Dysfunction-Associated Liver Disease (MASLD)

Introduction: MASLD affects ∼30% of the U.S. population, with prevalence rising. Metabolic dysfunction-associated steatohepatitis (MASH), a subtype, can progress to cirrhosis, hepatocellular carcinoma, and death. Studies show ∼5% weight loss can reduce steatosis, with up to 10% reversing steatohepatitis and fibrosis. About 650 million adults worldwide have obesity (body mass index ≥30), a key indicator for MASH and MASLD. Lifestyle interventions are key to treatment for both, yet clinical implementation remains inconsistent. Develop a lifestyle medicine-focused remote patient monitoring (RPM) program to treat and reverse MASLD and obesity by systematically integrating evidence-based interventions. Methods: Patients with MASLD or obesity were enrolled in an RPM program featuring a connected scale and mobile app for education, habit tracking, and self-monitoring. Monthly phone or video visits with a licensed practical nurse and registered dietitian followed a structured lifestyle medicine protocol—to optimize nutrition, physical activity, stress, sleep, or social connection at each visit—paired with personalized goals and coaching. Over 3 months, outcomes including weight loss, engagement, and adherence were tracked. Patient-reported outcomes were assessed using the PROMIS Global Health Scale 1.2. Pearson correlations evaluated the relationship between engagement (monthly weight readings and app logins) and weight loss. Results: Among 161 patients enrolled (82 with MASLD; 84 with obesity), 80% were women and the mean age was 63 years. Sixty-9 percent (n = 115) lost weight after ≥90 days in the program. Clinically meaningful weight loss—defined as a ≥3% reduction in body weight—was achieved by 32% (n = 53). Digital engagement was directionally positively associated with weight loss. Average monthly weight readings showed a weak but statistically significant correlation (r = 0.181, P = 0.019), as did monthly app logins (r = 0.164, P = 0.035). Patient-reported outcomes improved by 56% (n = 93), indicating benefit beyond weight loss. Among those reporting improvement, 46% had MASLD and 54% had obesity. Conclusion: A structured, diagnosis-specific remote care model integrating lifestyle medicine can drive meaningful weight loss and improvements in well-being. Digital engagement—through self-monitoring and app use—was modestly associated with better outcomes, highlighting the role of behavior change as a key tool in remote care. Future iterations of the program will explore group-based support to further enhance clinical impact and patient-reported outcomes.