(Toronto, September 9, 2026) Glucagon-like peptide-1 (GLP-1) medications have revolutionized weight management, yet high dropout rates and rapid weight regain remain significant hurdles for many patients. A new viewpoint paper published in the Journal of Medical Internet Research highlights a fundamental challenge: medication alone is not enough to secure long-term behavioral change. In the paper titled " Digital Behavioral Infrastructure for Glucagon-Like Peptide-1 Pharmacotherapy: Viewpoint on Persistence, Tolerability, and Postcessation Durability ," the author argues that while these drugs effectively target biological appetite, they do not inherently instill the lifestyle routines required to maintain health.
To bridge this gap, the paper introduces a "digital behavioral infrastructure"—a theory-driven approach that leverages digital health apps as essential structural companions, helping patients build sustainable habits during the medication's peak efficacy window. The paper maps how two well-validated theories of behavior change, social cognitive theory and behavioral economics, can be leveraged to drive medication persistence, side-effect mitigation, and durable weight loss.
Geoff Cook, CEO of Noom, a leading behavior change company, suggests an idea called the "habit window." By dialing down constant food cravings, described by patients as "food noise," GLP-1 drugs free up mental energy, opening a unique opportunity for patients to build healthier daily routines. He also proposes that GLP-1 therapy, when combined with behavioral support, may spark lifestyle change via the "Fresh Start" effect.
Digital companion programs use targeted strategies to address the three biggest hurdles of GLP-1 therapy. Personalized digital reminders can help patients stay consistent with their medication, while interactive symptom management features can help reduce gastrointestinal side effects so patients do not quit early. Finally, structured skill-building can help users establish sustainable eating and exercise routines before biological appetite cues return to baseline when treatment stops.
"Given the high rate of GLP-1 discontinuation," said Cook, "the objective becomes building healthy behaviors while the habit window is pharmacologically open. While the habit window is a hypothesis, the features suggested in the paper are not theoretical. In fact, these features are part of the Noom app today, as this is exactly how we've built Noom's GLP-1 Companion to take advantage of fast and slow thinking, system 1 and system 2. Most exciting of all is we will be supporting the research program outlined in Table 1 of the paper with RCTs to shed light on the problems, mechanisms, and interventions raised in the paper."
While early observational data shows promising results, the paper stresses that prospective, randomized trials are needed to fully test the "habit window" framework. Ultimately, pairing biological appetite control with digital behavioral coaching could mark the difference between temporary weight loss and a lifetime of improved health.
Please cite as:
Cook G. Digital Behavioral Infrastructure for Glucagon-Like Peptide-1 Pharmacotherapy: Viewpoint on Persistence, Tolerability, and Postcessation Durability
J Med Internet Res 2026;28:e104227
URL: https://www.jmir.org/2026/1/e104227
DOI: 10.2196/104227
About Noom
Noom is the leading behavior change company, empowering everyone, everywhere to live better longer – every day. Noom pairs sustainable behavior change with prescription-grade catalysts to make lasting change feel easy. Noom Health partners with top health plans and employers to offer millions of Americans a suite of metabolic health solutions – including Noom Clinical (Noom Med, Noom SmartRx, and NoomRx programs), Noom Weight, Noom Diabetes, and Noom Diabetes Prevention Program. Noom is building the future of preventive care and longevity medicine, leading the convergence of wearable-monitored behavior change, clinical care, diagnostics, and pharmacy into an integrated, AI-enhanced system that drives individualized, meaningful health outcomes.
Noom has received multiple grants from the NIH for digital health research and innovation and has been recognized by the CDC for its groundbreaking diabetes prevention programs. Headquartered in Princeton, NJ and with additional offices in New York City, Noom has been recognized as a TIME100 Industry Leader , on Newsweek's Most Trusted Brands list, and it's GLP-1 Companion Program has been recognized by U.S. News & World Reports as "Best for Supplemental Support" in its 2026 ranking of the Best GLP-1 Telehealth Companies. Learn more at noom.com , subscribe to our blog , or follow us on Twitter
