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Article History

Received: 18 August 2025

Accepted: 15 May 2026

First Online: 8 June 2026

Competing interests

: This work has been reviewed and approved by Johns Hopkins University in accordance with its conflict of interest policies. All opinions expressed and implied in this text are solely those of L.T.D. and do not represent or reflect the views of the Johns Hopkins University or the Johns Hopkins Health System. L.T.D., S.L.M. received a contract from WW to conduct this study. L.T.D.’s participation in this analysis was as a paid consultant for WW. D.F.T. was a member of the Scientific Advisory Board for WW from January 2015 to December 2024, and UNC received funding from WW for conducting clinical trials under her direction. S.L.P. was a member of the Digital Trial Advisory Board for WW from 2021 to 2023. J.W.A., A.M.P.’s institutions received funding from WW for conducting clinical trials under their direction. M.I.C. is a shareholder of WW and was an employee from March 2021 to November 2025. G.D.F. was a WW employee from July 2013 to December 2024. He is currently an employee and shareholder of Abbott. A.M.L. was an employee at WW from March 2022 to August 2024. A.M.L. is an employee and shareholder of Eli Lilly and Company. This work was completed prior to A.M.L.’s employment at Lilly. A.M.L. is acting entirely on her own, and this work is not in any manner affiliated with Lilly. S.L.F. was a WW employee from 2021 to 2022. J.M.J. is a member of the Scientific Advisory Board for Wondr Health Inc. R.J.R. is currently a consultant for Wondr Health Inc. All other authors declare no competing interests.