A new national program called Project Donor is helping people who want to donate kidneys or other organs but can’t because of health issues like being overweight or smoking. The program gives participants free access to weight loss programs, nutrition coaching, and help quitting smoking through virtual support. Out of 680 people who joined, 95 successfully lost weight and became eligible to donate, with 72 actually going on to donate organs. While the program shows promise, researchers note that many people dropped out and more studies are needed to understand how well this approach works long-term.

The Quick Take

  • What they studied: Can a support program help people who want to donate organs but are blocked by health problems like obesity or smoking?
  • Who participated: 680 people across the United States who wanted to be living organ donors but were initially rejected due to weight or smoking issues. The study ran from May 2022 to January 2025.
  • Key finding: About 14% of participants (95 out of 680) successfully lost an average of 18 pounds over 9.5 months and became eligible to donate. Of those who succeeded, 72 people actually went on to donate organs.
  • What it means for you: If you want to be an organ donor but have been told you’re not eligible due to weight or smoking, a structured support program with coaching and free resources may help you reach your goal. However, success requires commitment, and many people in the study did not complete the program.

The Research Details

Project Donor is a real-world program that enrolled 680 people who wanted to become living organ donors but couldn’t because of health barriers. Participants received personalized help from case managers who worked with them online, plus free access to popular weight loss programs like Noom and Weight Watchers, nutrition coaching, nicotine replacement therapy (like patches or gum to quit smoking), and counseling support. The program tracked how many people lost weight, quit smoking, and ultimately became eligible to donate organs between May 2022 and January 2025.

This type of study is called a ‘real-world implementation study’ because it shows how a program works when offered to actual people in practice, rather than in a controlled laboratory setting. Researchers looked at who succeeded, who dropped out, and what factors predicted success.

The United States has had the same number of living organ donors for over 20 years, which means many people waiting for transplants don’t get organs in time. This study is important because it shows that some people who are rejected as donors could become eligible if they had proper support and resources. Understanding what works can help hospitals and transplant centers offer better programs to expand the donor pool.

This study has some important strengths and weaknesses to understand. The strength is that it involved a large number of real people (680) across the entire country, making the results more representative of what could happen in practice. However, the study has significant limitations: there was no comparison group of people who didn’t receive the program, so we can’t be certain the program itself caused the weight loss. Additionally, the high dropout rate (64% of people quit the program) suggests the program may not work for everyone, and we don’t know why people left. The researchers acknowledge these limitations and call for more rigorous studies to confirm the findings.

What the Results Show

Out of 680 people enrolled in Project Donor, the outcomes broke down as follows: 142 people are still actively working toward their goals, 435 people dropped out of the program, and 95 people successfully reached their weight loss goals. Those who succeeded lost an average of 18 pounds over about 9.5 months.

People who successfully lost weight had some things in common: they started at a lower weight (about 206 pounds) compared to those who dropped out (about 224 pounds). They also had a lower starting BMI (a measure of weight relative to height). This suggests that people with less weight to lose may have found the goal more achievable.

The most exciting finding is that 72 of the 95 people who reached their weight loss goal went on to actually become living organ donors. This means the program not only helped people lose weight but also helped them fulfill their goal of saving someone’s life through organ donation.

The study found that participants who succeeded in the program had different starting characteristics than those who dropped out. Successful participants had lower starting weights and BMI measurements, suggesting that the amount of weight someone needs to lose may affect whether they stick with the program. The study also shows that free access to established programs like Weight Watchers and Noom, combined with personalized case management, can help people achieve meaningful health improvements. The fact that 72 people actually donated organs demonstrates that weight loss was not just a number on a scale but led to real health improvements that made donation possible.

This research builds on the known problem that many potential organ donors are rejected due to modifiable health conditions. Previous research has shown that obesity and smoking are major barriers to organ donation eligibility. Project Donor is one of the first large-scale attempts to systematically address these barriers with comprehensive support. While other weight loss programs exist, this is novel in specifically targeting people motivated by organ donation and providing free access to multiple evidence-based programs. The results suggest that motivation (wanting to save a life) combined with resources and support may be more effective than traditional weight loss programs.

Several important limitations affect how much we can trust and apply these findings. First, there was no control group—we don’t know if people would have lost weight anyway without the program. Second, the very high dropout rate (64%) means we’re only seeing results from people who stuck with it, which may not represent what would happen if the program was offered to everyone. Third, we don’t know why people dropped out or what factors would help more people succeed. Fourth, the study only tracked people for about 9.5 months on average, so we don’t know if people kept the weight off long-term. Finally, this program required significant resources (free programs, case managers, therapy), so it may not be practical or affordable to offer everywhere.

The Bottom Line

If you’re interested in becoming an organ donor but have been told you’re not eligible due to weight or smoking: A structured support program with personalized coaching and free access to evidence-based weight loss or smoking cessation programs may help you reach your goal. This approach appears promising based on this research, though success is not guaranteed. We recommend discussing with your transplant center whether similar programs are available. Confidence level: Moderate—the research shows promise but has limitations that prevent us from being highly confident.

This research is most relevant to: (1) People who want to be living organ donors but have been rejected due to weight or smoking, (2) Transplant centers and hospitals looking to expand their donor pool, (3) Healthcare providers who work with potential donors, (4) People interested in organ donation policy. This research is less relevant to people who don’t have weight or smoking barriers to donation, or those not interested in becoming donors.

Based on this study, people who successfully completed the program lost weight over about 9.5 months. However, individual timelines vary greatly. Some people may see results faster, while others may need more time. It’s important to have realistic expectations: this is not a quick fix, but rather a medium-term commitment to lifestyle change. The study doesn’t tell us how long people maintained their weight loss after the program ended.

Want to Apply This Research?

  • Track weekly weight and smoking status (cigarettes per day or quit date). Set a specific weight loss goal based on your transplant center’s requirements, and log progress weekly. Also track engagement with support resources (days using Noom, Weight Watchers meetings attended, nicotine replacement therapy use).
  • Use the app to connect with your case manager for weekly check-ins, log meals and exercise, track smoking urges and successes, and receive reminders about using nicotine replacement products. Set small weekly goals rather than focusing only on the final target weight.
  • Establish a long-term tracking plan that includes: (1) Monthly weight check-ins with your healthcare provider, (2) Weekly self-monitoring through the app, (3) Tracking of program engagement and support resource usage, (4) Regular communication with your case manager about barriers and successes. Plan for at least 6-12 months of active monitoring to achieve and maintain eligibility.

This research describes a specific program (Project Donor) and its results, but individual outcomes vary significantly. This information is educational and should not replace guidance from your transplant center or healthcare provider. If you’re interested in becoming an organ donor, consult with your medical team about your specific eligibility requirements and available support programs. The high dropout rate in this study (64%) indicates that success requires significant personal commitment. Always discuss any major health or lifestyle changes with your doctor before starting.