This research program includes two coordinated prospective studies (FLOURISH and THRIVE) evaluating the real-world effectiveness of Noom's digital health programs on weight, cardiometabolic biomarkers, physiological health indicators, and program engagement. FLOURISH is a 6-arm prospective cohort study comparing an Education-only control, Noom Weight, standard-dose compounded semaglutide, microdose compounded semaglutide, standard-dose tirzepatide (Noom Plus), and microdose tirzepatide (Noom Plus Microdose). THRIVE is a nested 2-arm prospective study comparing a Proactive Health program to a Noom Free Tier control. Participants complete monthly surveys, remote biomarker collection (Tasso device), connected-scale weigh-ins, and in-app biometric assessments (FaceScan, BodyScan). Microdose and Free Tier arms also use wearable fitness trackers. Primary outcomes are changes in cardiometabolic biomarkers, weight, body composition, and GLP-1 side effect profile. Total N = 2,310; 24-month duration.
FLOURISH (Functional Longitudinal Outcomes Under Repeated Intentional Small Habits) and THRIVE (Trajectories of Health, Resilience \& Integrated Vitality Evaluation) are designed to evaluate whether GLP-1 medications paired with a behavioral health digital companion delivered via the Noom application produce clinically meaningful improvements in weight, cardiometabolic biomarkers, physiological indicators, and patient-reported outcomes. All programs are commercially available Noom offerings. Research activities supplement but do not alter standard program care. Participants are recruited from active program users after program enrollment (GLP-1 programs, Noom Weight, Free Tier arms) or via an electronic recruitment platform (Education-only control). Measurement occurs at baseline and monthly through month 12, with additional follow-ups at months 18 and 24 for GLP-1 arms. Biomarker collection uses the FDA-cleared Tasso+ capillary blood device at baseline and months 2, 4, 8, and 12. Connected scales provide monthly weight data. Wearable fitness trackers (arm-specific) provide continuous physiological data including resting heart rate, HRV, SpO2, and sleep. In-app BodyScan and FaceScan capture body composition and HRV estimates monthly. Self-report measures assess depression (PHQ-8), anxiety (GAD-7), sleep (PROMIS Sleep Disturbance), vitality (Subjective Vitality Scale), health-related quality of life (PROMIS PROPr), flourishing (PERMA), appetite and food cravings (Mind-Eat, Food Noise Questionnaire, PACS), and GLP-1 side effects and medication adherence. Conflict of interest: Noom, Inc. is both sponsor and developer of the interventions under study. This is disclosed to all participants and will be reported in publications.
Study Type
OBSERVATIONAL
Enrollment
2,310
App-based behavioral weight management program providing structured educational content, coaching, and self-monitoring tools focused on nutrition, physical activity, and habit formation.
Basic free-to-use tier of the Noom app with limited features; no structured behavioral program or medication.
Weekly informational newsletters based on the CDC curriculum for 12 months; no structured behavioral program or medication.
Standard clinical dosing of compounded semaglutide as part of Noom Med GLP-1Rx program per clinical standard of care, combined with behavioral coaching via the Noom app.
Standard clinical dosing of tirzepatide as part of Noom Plus program per clinical standard of care, combined with enhanced behavioral coaching.
Below-standard clinical dosing (microdose) of compounded semaglutide as part of Noom Med GLP-1Rx Microdose program, combined with behavioral coaching via the Noom app.
Below-standard clinical dosing (microdose) of tirzepatide as part of Noom Plus Microdose program, combined with enhanced behavioral coaching.
Noom, Inc.
Princeton, New Jersey, United States
Change in Body Weight
Change from baseline in body weight (kg/lbs) measured via connected scale.
Time frame: Monthly, Baseline through Month 12 (and Months 18 & 24 for FLOURISH GLP-1 arms)
Change in fasting glucose
Change from baseline in fasting glucose (milligrams per deciliter (mg/dL)) measured via Tasso+ capillary blood collection device.
Time frame: Baseline, Month 2, Month 4, Month 8, Month 12
Change in HbA1c
Change from baseline in HbA1c (mmol/mol and percentage) measured via Tasso+ capillary blood collection device.
Time frame: Baseline, Month 2, Month 4, Month 8, Month 12
Change in LDL cholesterol
Change from baseline in LDL cholesterol (milligrams per deciliter (mg/dL)) measured via Tasso+ capillary blood collection device.
Time frame: Baseline, Month 2, Month 4, Month 8, Month 12
Change in HDL cholesterol
Change from baseline in HDL cholesterol (milligrams per deciliter (mg/dL)) measured via Tasso+ capillary blood collection device.
Time frame: Baseline, Month 2, Month 4, Month 8, Month 12
Change in total cholesterol
Change from baseline in total cholesterol (milligrams per deciliter (mg/dL)) measured via Tasso+ capillary blood collection device.
Time frame: Baseline, Month 2, Month 4, Month 8, Month 12
Change in triglycerides
Change from baseline in triglycerides (milligrams per deciliter (mg/dL)) measured via Tasso+ capillary blood collection device.
Time frame: Baseline, Month 2, Month 4, Month 8, Month 12
Change in Body Composition
Change from baseline in estimated body composition metrics (lean mass, fat mass percentage) as measured via in-app BodyScan feature.
Time frame: Monthly, Baseline through Month 12 ((and Months 18 & 24 for FLOURISH GLP-1 arms)
GLP-1 Side Effect Profile
Number, severity, and tolerance of GLP-1 medication-related side effects (nausea, vomiting, diarrhea, constipation, headache, fatigue, injection site reactions) assessed via monthly self-report. Applicable to GLP-1 arms only.
Time frame: Baseline (pre-treatment), Monthly through Month 12
Change in heart rate variability (HRV)
Change in heart rate variability (HRV) from baseline measured via in-app FaceScan feature (all arms) and wearables (select arms).
Time frame: Collected monthly from baseline through month 12 and at months 18 and 24 for the FLOURISH GLP-1 program.
Change in resting heart rate (RHR)
Change in resting heart rate (RHR) from baseline measured via wearables (select arms).
Time frame: Collected monthly from baseline through month 12 and at months 18 and 24 for the FLOURISH GLP-1 program.
Change in Peripheral Capillary Oxygen Saturation (SpO2)
Change in Peripheral Capillary Oxygen Saturation (SpO2) from baseline measured via wearables (select arms).
Time frame: Collected monthly from baseline through month 12 and at months 18 and 24 for the FLOURISH GLP-1 program.
Change in sleep duration
Change in sleep duration (hours and minutes) from baseline measured via wearables (select arms).
Time frame: Collected monthly from baseline through month 12 and at months 18 and 24 for the FLOURISH GLP-1 program.
Change in time spent in sleep stages
Change in time spent in sleep stages (hours and minutes spent in each sleep stage) from baseline measured via wearables (select arms).
Time frame: Collected monthly from baseline through month 12 and at months 18 and 24 for the FLOURISH GLP-1 program.
Change in sleep continuity
Change from baseline in wearable-derived sleep continuity, assessed as sleep onset latency (SOL) and wake after sleep onset (WASO), measured in minutes.
Time frame: Collected monthly from baseline through month 12 and at months 18 and 24 for the FLOURISH GLP-1 program.
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