Access by Design: Why the Last Mile of Obesity Care Can’t Be Another App
- Puneet Seth
- Oct 20
- 5 min read
Updated: Oct 20
We have reached an inflection point in caring for people with obesity.
Medications are proving effective for many, and innovation in pharmacotherapy and behavioral programs is accelerating. Yet there remains a widening gap between the promise of obesity therapeutics and the reality of implementation.
For millions, access is still an impossible hurdle, not just because of cost, which will likely decline over time, but because the digital tools meant to support care often become barriers themselves.
It is now well understood that effective chronic disease care requires more than the physician, care team, and patient triad. Yet the current wave of chronic disease management apps and platforms has profound limitations, and nowhere is this clearer than in obesity care.
Imagine being told you have a “chronic condition” called obesity, a term society has long framed as a lifestyle issue. You are prescribed a medication that works but comes with a new app you are expected to use for support. Between work, family, and daily responsibilities - all on a phone that struggled with new apps - you’re asked to create another login and navigate yet another interface. Is it any wonder you rarely open it?
Meta-analyses show that sustained use of mobile apps for chronic disease is extremely low, often under 2 percent over time, with average engagement lasting only a few weeks. Most people do not want to log into an app daily to manage a chronic condition, no matter how much content or gamification it offers. So in the end, how much support are we really providing and to whom?
When it comes to obesity, well known names like Noom, Omada and Virta acknowledge its complexity - yet ironically design programs that last only 10, 16, or 24 weeks, despite obesity being a lifelong, multifactorial disease.
Another reality: people who do use mobile health apps tend to be younger, higher income, more educated, living in urban environments, largely English-speaking, and often healthier. This is not the demographic of the people at highest risk of negative outcomes from obesity. Those who most need long-term support are the least likely to get it through these digital channels.
For chronic disease management, the kind of long, behavior-intensive journey obesity care requires, this mismatch is profound. People do not need another sleek interface or short-term challenge; they need tools that integrate into already busy, complex lives.
As technologists, we often throw more technology at problems, even when the data shows we are getting further from the goal.
Meeting People Where They Already Are: Messaging as Universal Infrastructure
Rather than asking someone to download another app, create new credentials, and learn an interface, we asked a simpler question:
What communication channels are people already using every day?
Across nearly all demographics, the answer is messaging: SMS, WhatsApp, RCS, and other universal chat tools.
In healthcare, people are already overwhelmed by digital portals and mobile apps from their providers, insurers, and support programs. Adding another one increases friction. Messaging, on the other hand, reduces it.
Messaging works across age groups, devices, and languages, with remarkably low barriers. For older adults, simply removing the need to install or learn new software opens the door to engagement. Because messaging platforms are ubiquitous, multilingual, and cross-device, they represent an equitable medium for care, not just for digital natives, but for everyone.
True access means using the channels people already use, not asking them to adopt another new app.
Evolution of consumer messaging
Messaging today is not just a basic text. With modern standards like Google’s Rich Communication Services (RCS), the next innovation in messaging after SMS, users experience higher-fidelity communication: rich media, read receipts, group chat, and optional end-to-end encryption.
RCS now connects over one billion active users monthly, and because it is an open standard, people are not confined to a single ecosystem.
For healthcare organizations, this enables familiar, secure, and scalable communication through channels patients already trust.
No new downloads. No forgotten logins. No unnecessary complexity.
That is the essence of access by design: ensuring the medium itself does not become the barrier.
Built for Partners: nymble as Last-Mile Infrastructure
Access by design does not stop at messaging. Many patients are already connected to their healthcare providers meaningfully through existing portals or mobile apps. nymble is built to fit within those systems, not to displace them.
Our API-driven platform integrates seamlessly into the workflows of enterprise partners, enabling expert-level conversational support without creating another front-end for patients. nymble can be embedded as a white-label chat inside existing digital properties, whether that is a health system’s portal, a pharmacy app, or a life sciences patient-support platform.
Here’s how it works in practice:
Health systems: a patient logs into their existing web portal and chats through the same interface. Behind the scenes, nymble powers triage, education, and proactive side-effect management for obesity.
Life sciences PSPs: a white-label version of nymble provides multilingual check-ins, behavioral education, adverse-event capture, and benefit navigation through the patient’s preferred channel—SMS, WhatsApp, or RCS.
Pharmacies: nymble integrates into branded apps, managing common medication questions and escalating to pharmacists only when necessary, all without disrupting established workflows.
Partner value at a glance:
Embeds directly into portals and PSPs so users stay within their existing environment.
Multilingual by default, with conversations delivered in the patient’s language.
Scalable human-in-the-loop model: automation handles routine engagement, educators step in when needed.
Structured outcomes and analytics on reach, engagement, and equity built in.
Because nymble runs through messaging and API-based integrations, it is inherently modular. That design choice means our content can be regionalized, localized, and customized far more efficiently than traditional digital health solutions. Partners can adapt messaging, tone, and educational materials by geography, language, or population. This efficiency also drives cost savings, which we return directly to our customers and collaborators through lower operational costs and faster deployment cycles.
The Bottom Line: Infrastructure for Everyone
If we are serious about closing the access gap in obesity care, we cannot contribute to the saturation of mobile health apps and creation of additional digital barriers. We must build infrastructure - systems that reach people where they already are.
nymble is designed for that last mile.
It is what happens when you align technology with empathy, workflows with lived experience, and communication with real-world behavior and expertise.
Because access is not just about affordability.
It is about designing care that everyone can actually reach.
To healthcare organizations interested in learning more, contact us at info@nymble.health, and if you’re going to be at HLTH (Las Vegas), Obesity Week (Atlanta), the Patient Support Summit (Toronto), or the CAN Health Network Annual Conference (Toronto), reach out to us via LinkedIn or email to coordinate a meeting - we’ll be there.
