The NUTRI-OBEDIGITHUM Pathway: Integrating Personalized Exchange-Based Nutrition into Digitally Enabled Obesity Care and a Retrospective Real-World Cohort Analysis.

BACKGROUND/OBJECTIVES: Obesity care requires nutritional prescriptions that are individualized, nutritionally coherent, understandable, and feasible within high-volume clinical services. We describe the NUTRI-OBEDIGITHUM pathway, which integrates multidimensional digital phenotyping, clinician-supervised exchange-based nutritional prescription, patient-oriented materials, and structured education, and we report preliminary descriptive outcomes from a retrospective real-world cohort. METHODS: This descriptive methodological and operational study included a retrospective observational analysis of anonymized routine-care data. NUTRI-OBEDIGITHUM integrates OBEDIGITHUM, a digitally enabled obesity-care pathway, with Dietcamb®, a software-supported method that translates individualized energy and macronutrient targets into food exchanges, meal distributions, household measures, food lists, and example menus. The source database comprised 3928 unique patients. Among patients with a plausible baseline weight and an observable 6-month window, the eligible outcome was the measurement closest to day 183 within ±60 days, after prespecified plausibility checks. Baseline characteristics were compared descriptively according to outcome availability. Baseline medication exposure was assessed using free-text mentions only. RESULTS: By the data cutoff, the 6-month window had opened for 3215 patients; 929 (28.9%) had an eligible 6-month weight and 2286 (71.1%) did not. In the analyzed cohort, mean age was 53.7 ± 14.0 years, 70.5% were women, and mean body mass index was 35.9 ± 6.3 kg/m2. Mean weight changed from 98.5 ± 20.7 kg at baseline to 94.2 ± 20.3 kg at follow-up, corresponding to a descriptive paired change of -4.3 kg (95% CI -4.7 to -3.9); median total body-weight loss was 3.4%. Losses of at least 5%, 10%, and 15% were observed in 39.6%, 17.8%, and 6.4% of patients, respectively. A baseline GLP-1 receptor-agonist mention was present in 151/929 patients (16.3%); medication timing, dose, duration, dispensing, persistence, and adherence were unavailable. CONCLUSIONS: NUTRI-OBEDIGITHUM provides an operational framework for converting multidimensional obesity phenotyping into a structured, flexible, clinician-supervised, and patient-oriented nutritional prescription. The observed weight trajectories are descriptive complete-case findings from a selected, uncontrolled cohort and cannot establish the independent effectiveness of the pathway, Dietcamb®, or pharmacotherapy. Prospective studies should evaluate reach, adoption, fidelity, usability, adherence, nutritional adequacy, safety, NUTRI-specific workload and cost, and metabolic outcomes.