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This study assessed short-term effectiveness of FitterLife, a 12-week digitally delivered, group-based behavioural programme for at-risk community adults without diabetes or hypertension. In a retrospective matched cohort, 306 participants (Oct 2021–Jan 2025) were compared with 5087 matched controls. Success required ≥5% weight loss or ≥1 kg/m2 BMI reduction at 12 weeks, using propensity score matching and weighted regression. 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Manohari 1, Donna Tan 2 and Elaine Tan 3  \nAcademic Editor: Antonio Cepeda-Benito  \nReceived: 7 November 2025  \nRevised: 9 December 2025  \nAccepted: 16 December 2025  \nPublished: 19 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Health Services and Outcomes Research, National Healthcare Group, NHG Health (Annex),  \n1 Mandalay Road, Singapore 308205, Singapore; [joseph.antonio.molina@nhghealth.com.sg](joseph.antonio.molina@nhghealth.com.sg) (J.A.D.C.M.); [michelle.jessica.pereira@nhghealth.com.sg](michelle.jessica.pereira@nhghealth.com.sg) (M.J.P.)  \n2 National Healthcare Group Polyclinics, National Healthcare Group, NHG Health (Annex), 1 Mandalay Road, Singapore 308205, Singapore  \n3 Clinical Transformation, National Healthcare Group, NHG Health (Annex), 1 Mandalay Road, Singapore 308205, Singapore; [elaine.tan@nhghealth.com.sg](elaine.tan@nhghealth.com.sg) (E.T.)  \n* Correspondence: [lixia.ge@nhghealth.com.sg](lixia.ge@nhghealth.com.sg); Tel.: +65-6038-3697  \nAbstract  \nBackground: The high prevalence of overweight and obesity in Singapore necessitates scalable primary prevention strategies. This study evaluated the short-term effectiveness of FitterLife, a 12-week, digitally delivered, group-based behavioural weight management programme targeting at-risk adults without diabetes or hypertension in the community. Methods: In a retrospective matched cohort study, we compared 306 FitterLife participants (enrolled from October 2021 to January 2025) with 5087 controls identified from a population health data mart, matched on age, sex, ethnicity, and baseline body mass index (BMI) . The primary outcome was achieving ≥5% weight loss or a ≥1 kg/m2 BMI reduction at 12 weeks. Programme effectiveness was analysed using propensity score matching (1:1) and inverse probability weighted regression. Mixed-effects models assessed weight/BMI trajectories and modified Poisson regression identified behavioural factors associated with success. Results: After matching, FitterLife participants were more likely to achieve the weight loss target than controls (45.7% vs. 13.7%, coefficient = 0.32, 95% confidence interval [CI]: 0.26–0.38) and were over three times as likely to succeed (Adjusted incidence rate ratio [aIRR] = 3.37, 95% CI: 2.87–3.93) . The programme group showed significant reductions in weight (−2.23 kg, 95% CI: −2.57 to −1.90) and BMI (−0.86 kg/m2, 95% CI: −0.95 to −0.73) at the end of programme. Higher session attendance and improved behavioural factors were associated with success. Conclusions: FitterLife was effective in achieving clinically significant short-term weight loss in a real-world setting. The findings demonstrate the potential of a scalable, behavioural theory-informed, virtual group model as a viable primary prevention strategy within national chronic disease management efforts.  \nKeywords: behavioural intervention; body mass index; digital health; primary prevention; programme evaluation; weight management  \n1. Introduction  \nOverweight and obesity have emerged as a pressing global public health challenge, strongly associated with over 50 medical conditions including type 2 diabetes, hypertension, cardiovascular disease, several cancers, and musculoskeletal disorders [1–3] . Beyond health impact, obesity imposes a staggering societal burden: elevated BMI accounted for  \n3.7 million deaths from non-communicable diseases in 2021 [4], can reduce life expectancy by 5 to 20 years [5,6], and generates substantial economic costs through healthcare expenditure and reduced productivity [3] . Global economic losses linked to over","cbCain5Kwaw7Ms5S","https://ap.wps.com/l/cbCain5Kwaw7Ms5S","pdf",1169140,15,"English","# Abstract\n# Introduction","[{\"question\":\"What is FitterLife and who is it designed for?\",\"answer\":\"FitterLife is a 12-week, digitally delivered group-based behavioural weight management programme for at-risk adults in the community without diabetes or hypertension.\"},{\"question\":\"How was the programme’s effectiveness evaluated in the study?\",\"answer\":\"A retrospective matched cohort compared 306 FitterLife participants with 5087 matched controls. Propensity score matching and inverse probability weighted regression were used, and mixed-effects models assessed weight/BMI trajectories.\"},{\"question\":\"What outcomes indicated that FitterLife worked short term?\",\"answer\":\"After matching, participants were more likely to achieve the target of ≥5% weight loss or a ≥1 kg/m2 BMI reduction. The programme group also showed significant end-of-programme reductions in weight and BMI, and higher session attendance was associated with success.\"}]","Effectiveness of FitterLife - A Community-Based Virtual Weight Management Programme for Overweight Adults | PDF",1790772836,38]