Reduce Participant Dropout in Anti-Obesity Medication Trials

Participant discontinuation can undermine the statistical power, interpretability, and regulatory readiness of anti-obesity medication (AOM) trials. With attrition rates of 15–30% reported across major Phase 3 programs, sponsors need a more proactive, evidence-based approach to participant engagement and retention.

This whitepaper from Signant Health’s Science & Medicine team explores the clinical, operational, and regulatory implications of participant dropout in GLP-1 and other incretin-based AOM trials. It outlines a practical, scalable framework for identifying attrition risk early and implementing support strategies designed around the realities participants face throughout long-term studies.

In this whitepaper, you'll learn:

• Why participant dropout is more than a data-completeness issue—and how it can affect statistical power, bias, intercurrent-event planning, and the interpretability of efficacy and safety findings.

• What drives attrition in obesity trials, including treatment burden, gastrointestinal adverse events, perceived lack of efficacy, frequent visits, and the demands of managing a chronic condition over time.

• Which evidence-based engagement approaches have demonstrated reductions in attrition risk, including financial incentives, self-monitoring, structured support, teleconference contact, and tailored goal-setting methods.

• How to apply a four-layer retention framework that combines engagement design, goal-setting implementation, predictive analytics, and bias-aware standardization.

• How ePRO metadata, engagement scoring, and tiered site-intervention protocols can help teams identify potential dropout risk before a participant discontinues.

• What Signant has learned from supporting obesity and GLP-1 clinical trials across a global network of research sites and participants.

Why this matters now

Regulatory expectations for obesity-drug development continue to emphasize the importance of integrating scalable lifestyle-modification support alongside pharmacotherapy. For sponsors designing, amending, or operationalizing AOM studies, participant engagement should be treated as a deliberate study-design and operational strategy, not an afterthought.

Drawing on published evidence, Signant’s clinical-trial experience, and analysis of obesity Phase 2 and Phase 3 studies, this whitepaper provides practical considerations for building retention strategies that are both participant-centered and operationally feasible at scale.

"The question is no longer whether we can solve this problem. The evidence demonstrates that we have both the understanding and the tools to transform participant retention in obesity trials. The imperative now is to implement these proven solutions rapidly and systematically across the industry."
— Dawie Wessels, MD, Chief Medical Officer, Signant Health 

Download the whitepaper to explore the evidence, implementation considerations, and predictive approaches that can help protect participant retention—and the integrity of your AOM trial.

Planning a GLP-1 or anti-obesity medication trial?
Discuss a participant-retention strategy tailored to your program with a Signant clinical engagement expert. Speak to an expert. 

AUTHOR BIOS 

Marcela Roy, MA, ACC serves as Executive Director of Clinical Science & Medicine, bringing over 20 years of clinical and research expertise to her role. She provides strategic leadership across CNS and non-CNS therapeutic areas, with particular expertise in psychedelic research and central ratings data quality monitoring methodologies.

Alan Kott, MUDr, is based in Signant’s Prague office and until recently was Senior Clinical Manager for Europe. Having led the development of the Data Analytics Program for Bracket, he has overseen the design and reporting of data analytics in multiple large schizophrenia studies. For the past seven years, he has also provided training to investigators as an Expert Trainer.

Dr. Dawie Wessels is Chief Medical Officer of Signant Health, bringing deep expertise across multiple therapeutic areas, multinational development leadership, and experience in associated commercial growth to support the expanding impact of the Signant Science and Medical team. With over twenty years' experience combining medicine and business, he oversees Signant's scientific and operational strategies.

Lauren Crooks, MSc, has comprehensive cross-functional experience within the life sciences and information technology sectors. At Signant, she combines this experience to provide scientific consultation and support to clients on the implementation of eCOA to optimize patient care and outcomes in clinical trials. She has supported eCOA projects across multiple therapeutic areas, including dermatology and neurology, with a current focus on respiratory diseases.

Dr. Graham C. Ellis is Clinical Vice President at Signant Health. A specialist physician with more than 25 years of experience in diabetes, endocrinology, and metabolic disease, he has served as Principal Investigator on more than 150 international clinical trials. Dr. Ellis previously served as Executive Director of Medical Science and Strategy at PPD, the clinical research business of Thermo Fisher Scientific, and is a founding member of the Centre for Diabetes and Endocrinology (CDE).

Dr. Elias Ketiar, MRCP, serves as the Clinical Vice President, Science & Medicine, at Signant Health. Dr. Ketiar draws on his wealth of more than 20 years of academic and clinical experience to advise on clinical trial design, execution, and governance.