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Abstract Aims Telehealth became a patient necessity during the COVID pandemic and evolved into a patient preference in the post‐COVID era. This study compared the % total body weight loss (%TBWL), HbA1c reduction, and resource utilization among patients with obesity and diabetes who participated in lifestyle interventions with or without telehealth. Methods A total of 150 patients with obesity and diabetes who were followed every 4–6 weeks either in‐person (n = 83) or via telehealth (n = 67), were included. All patients were provided with an individualized nutritional plan that included a weight‐based daily protein intake from protein supplements and food, an activity/sleep schedule‐based meal times, and an aerobic exercise goal of a 2000‐calorie burn/week, customized to patient's preferences, physical abilities, and comorbidities. The goal was to lose 10%TBWL. Telehealth‐based follow‐up required transmission via texting of weekly body composition measurements and any blood glucose levels below 100 mg/dl for medication adjustments. Weight, BMI, %TBWL, HbA1c (%), and medication effect score (MES) were compared. Patient no‐show rates, number of visits, program duration, and drop‐out rate were used to assess resource utilization based on cumulative staff and provider time spent (CSPTS), provider lost time (PLT) and patient spent time (PST). Results Mean age was 47.2 ± 10.6 years and 74.6% were women. Mean Body Mass Index (BMI) decreased from 44.1 ± 7.7–39.7 ± 6.7 kg/m2 (p |