Exploring real-world user experiences of GLP-1 receptor agonist therapy for obesity treatment, and barriers and motivators to adherence

Abstract

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) demonstrate efficacy for weight loss in clinical trials, yet real-world implementation challenges remain poorly understood.

Aim: This study aimed to evaluate current and former user experiences of GLP-1RA medications for obesity treatment in the UK.

Methods: A cross-sectional online survey was administered via Prolific to 352 current and 272 former GLP-1RA users. Questionnaires were designed to gather data on 1) Participant characteristics, 2) Medication use, access and provision, 3) Motivations, experiences and perceived outcomes, 4) Healthcare provider support, 5) Barriers and motivators to adherence, and 6) Discontinuation and post-treatment impacts. Data were presented descriptively, as well as inferentially using chi-squared tests to compare differences in experiences between current and former users and between demographic subgroups.

Results: Current users were more likely than former users to report that the medication helped them achieve their goals (84% vs. 67%, p<0.001). Treatment was predominantly accessed privately online, but to a greater extent in current users (current: 76%, former: 58%, p<0.001). Healthcare support was generally reported as adequate overall (current: 62%, former: 54%, p=0.02) but rated consistently lower for dietary (current: 49%, former: 49%, p=0.79), physical activity (current: 36%, former: 37%, p=0.71), and psychological care (current: 27%, former: 28%, p=0.71). Cost emerged as the primary barrier to adherence and main reason for discontinuation (31%), disproportionately affecting lower socioeconomic groups. The prevalence of significant side effects was higher in former than current users (38% vs. 29%, p=0.02) and contributed to 25% of discontinuations. Post-discontinuation, 45% reported weight regain, 40% maintained weight, and 15% continued losing weight.

Conclusion: GLP-1RA therapy supports weight management in real-world settings, but long-term effectiveness is limited by high costs, insufficient multidisciplinary support, and side effects. For NHS practice, improving equitable access and embedding structured, multidisciplinary follow-up will be critical to optimise adherence and sustain outcomes.