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Introduction Successful obesity treatment involves frequent follow-up contacts, but the use of mHealth contacts has not been evaluated. We aimed to investigate patients’ use of an mHealth chat in their obesity treatment.Methods In this descriptive observational study, we included 492 patients, 16 years or older, from a specialist obesity treatment clinic in Sweden. We assessed chat usage during their first 6 months of treatment, and compared subgroups, considering factors such as age, sex, body mass index (BMI), socioeconomic status, prescribed weight management medications and digital welcome letter.Results Participants had a mean BMI of 42.5 kg/m 2 and a mean age of 30.5 years, 73.4% were women. Over 90% of participants had low socioeconomic status and 23.8% were prescribed weight management medications. Almost all participants (90%) used the chat function during their first 6 months of treatment. Younger participants, those prescribed weight management medications, and those who received a digital welcome letter before admission were the most active users. Socioeconomic status or sex did not appear to be associated with chat activity.Conclusion Integrating mHealth solutions, including chat function, into obesity treatment programmes can be a way to maintain patient contact, also for patients with low socioeconomic status. Healthcare provider-initiated digital interactions may encourage greater patient engagement.