What this is
- This research assesses community awareness and attitudes toward () as obesity treatments in Saudi Arabia.
- An online survey was conducted with 398 participants to evaluate their knowledge and perceptions.
- Findings indicate a moderate to high level of awareness, with significant variations based on income and previous use of GLP-1 .
Essence
- Participants showed a moderate to high awareness of GLP-1 enhancers, primarily using them for weight loss. Familiarity varied significantly with income levels and prior usage.
Key takeaways
- 72.6% of participants had heard of GLP-1 enhancers, with Mounjaro being the most recognized. This reflects a significant public awareness of these medications.
- 80.4% reported using GLP-1 enhancers for weight reduction, indicating a strong association between these drugs and weight management in public perception.
- Individuals earning between 5000 to 10,000 SAR had significantly lower knowledge of GLP-1 enhancers compared to those earning less than 5000 SAR, highlighting income-related knowledge gaps.
Caveats
- The study's online survey design may limit generalizability, as it primarily represents individuals with internet access. This could skew the understanding of broader community awareness.
- The convenience sampling method may not adequately capture the diversity of opinions and knowledge across different demographics.
Definitions
- GLP-1 receptor agonists (RAs): A class of medications that stimulate insulin secretion and suppress glucagon release, used in diabetes and obesity management.
Simplified
1. Introduction
Diabetes mellitus (DM) is considered a potentially life-threatening medical condition, associated with a range of severe chronic and acute outcomes.Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are now an anchor drug class in the treatment of type 2 DM and obesity management.With their mechanism of action, they cause effects through the secretion of insulin, suppression of glucagon release, and increased satiety, leading to improved glycemic control along with significant weight loss.Given their growing role in metabolic disease management, it is important to understand public perception, usage patterns, and attitudes toward GLP-1 RAs in a bid to ensure maximum patient compliance and education. [–] 1 3 [] 4 [] 5
Although clinically well understood, knowledge gaps also exist for GLP-1 RAs regarding their indications, side effects, and contraindications.Previous studies have delineated variations in levels of awareness as a function of socio-demographic factors, access to health services, and media exposure.Patient adherence to GLP-1 RAs has also been previously influenced by self-perceived efficacy, probability of side effects, and patient trust in healthcare providers.Therefore, consideration of determinants of attitude and knowledge towards such drugs is essential in creating educationally focused interventions as well as enhancements in treatment outcomes. [] 6 [] 7 [] 8
According to the General Authority for Statistics in Saudi Arabia, the obesity rate in 2024 reached 23.1% among individuals aged 15 years and older. Additionally, 45.1% of those individuals are classified as overweight.GLP-1 RAs are now considered a cornerstone in effective obesity management protocols.This is supported by wide-ranging evidence from randomized controlled trials and meta-analyses.The use of GLP-1 RAs is associated with weight loss of 4 to 16 kg.Moreover, treatment guidelines recommend these medications as first-line therapy among various patient groups, specifically those with comorbid conditions. [] 9 [] 10 [] 11 [,] 11 12 [] 13
This study aims to identify the level of awareness and knowledge about GLP-1 RAs among the general public in Saudi Arabia. The specific objectives were to identify sources of information considered most important and to investigate the determinants of differences in knowledge. By conducting demographic characteristics analysis, history of exposure to drugs, and information channels of dissemination, this study presents various insights regarding patient attitudes to GLP-1 RAs. The findings will inform public health interventions aimed at increasing awareness and promoting informed decision-making regarding the use of these drugs.
2. Methods
2.1. Study design
This is an online survey study that was conducted in Saudi Arabia between December 2024 and January 2025.
2.2. Study population and sampling technique
Saudi Arabian males and females from the general public aged between 18 and 65 made up the study's population. Males and females between the ages of 18 and 65 who reside in Saudi Arabia were eligible to participate. Saudi and non-Saudi individuals who reside outside Saudi Arabia and are younger than 18 or older than 65 were excluded.
A convenience sampling technique was used to recruit the participants for this study. Social media platforms, including WhatsApp and Facebook, were used to circulate the questionnaire link and recruit participants. The questionnaire link included an invitation letter highlighting the study's aims and inclusion criteria. Participants who met the inclusion criteria were asked to participate in the study.
2.3. Questionnaire tool
The questionnaire tool for this study was developed based on an extensive literature review.The questionnaire was created in the Arabic language. The questionnaire examined participants' characteristics (age, gender, education level, income, body mass index, family member working in healthcare, and having a history of DM). Additionally, the questionnaire examined familiarity with GLP-1 types, sources of information, utilization patterns, side effects, and contraindications, and awareness, perceptions, and concerns regarding GLP-1 enzyme enhancers. The questionnaire instrument was formatted in a multiple-choice format. The knowledge score had 4 items; the median summation of the items was used as a cutoff point for categorizing the score into poor and good knowledge. [,] 14 15
The external validity of the questionnaire tool was checked by 2 clinical pharmacists. They confirmed that the questionnaire tool covered the study objectives with no editing needed. This was followed by a pilot study on 25 participants who met the inclusion criteria for this study. The participants were asked about the questionnaire items, and they confirmed that they were clear and understandable.
2.4. Ethical approval
Ethical approval for this study was obtained from the Research Ethics Committee at King Faisal University (KFU-REC-2024-NOV-ETHICS2880). All participants provided their consent before participating in the study.
2.5. Data analysis
Categorical variables were presented in terms of frequency and percentage. A multiple logistic regression was performed with knowledge as the dependent variable; demographic and other variables were utilized as independent variables. The findings of the regression analysis were presented as odds ratios along with their corresponding 95% confidence interval. The level of significance was defined as a-value <.05. The data were analyzed using Statistical Package for the Social Sciences (SPSS), version 29. P
3. Results
A total of 398 participants were included in the analysis. The majority of participants (221, 55.5%) were aged between 19 and 39 years, followed by those between 40 and 59 years (124, 31.2%). The majority of participants (307, 77.1%) were females, with 91 males (22.9%). Regarding monthly income, 155 (38.9%) had a monthly income between 5000 and 10,000 Saudi Arabian riyals (SAR), and 125 participants (31.4%) earned <5000 SAR monthly. Most participants (261, 65.6%) had a bachelor's degree, followed by 99 participants who had only a high school degree (24.9%). Additional demographic characteristics are provided in Table. Regarding the GLP-1 enhancers, the majority (289, 72.6%) had heard about the term before participating in the online survey. According to our participants, the most familiar one was Mounjaro (262, 65.8%), followed by Ozempic (237, 59.5%), while only 68 participants (17.1%) had heard about Saxenda. More details in Table. 1 2
Among the sources of information, social media was the most common (227, 57.0%), followed by friends and family (153, 38.4%) and healthcare professionals (105, 26.4%). The majority reported using GLP-1 enhancers for weight reduction (319, 80.4%) and glucose control (212, 53.3%), while fewer used them for reducing the risks of obesity related disease (117, 29.4%). Common side effects included loss of appetite (276, 69.3%), vomiting (196, 49.2%), and abdominal pain (188, 47.2%). The most frequently mentioned contraindications were pregnancy and lactation (295, 74.1%), pediatric age group (204, 51.3%), and kidney conditions (171, 43.0%). More details in Table. 3
A total of 175 participants (44.0%) reported being fully aware of this type of medication and its uses, and a higher percentage (272, 68.3%) claimed to know about their potential side effects. Trust in healthcare providers as a source of information was high, with 312 participants (78.4%) agreeing they are trustworthy. Additionally, 239 participants (60.1%) felt confident in adhering to the treatment plan, and 297 individuals (74.6%) recognized the importance of regular follow-up appointments (Table). 4
Significant associations were observed between income and prior use of these medications. Individuals with an income between 5000 to 10,000 had significantly less knowledge of GLP-1 enhancers compared to those earning <5000 SAR (OR = 018, 95% CI: 0.03–0.99, = .04). Additionally, individuals who had previously used or were currently using GLP-1 enhancers were significantly more likely to have better knowledge (OR = 6.56, 95% CI: 1.82–23.66, = .004). Additional details about factors that influenced participants' knowledge are provided in Table. P P 5
| Demographic characteristics | N | % |
|---|---|---|
| Age (yr) | ||
| <18 | 21 | 5.3 |
| 19–39 | 221 | 55.5 |
| 40–59 | 124 | 31.2 |
| 60–64 | 32 | 8 |
| Gender | ||
| Female | 307 | 77.1 |
| Male | 91 | 22.9 |
| Education level | ||
| Less than high school | 17 | 4.3 |
| High school | 99 | 24.9 |
| Bachelor | 261 | 65.6 |
| Higher than bachelor | 21 | 5.3 |
| Income (SAR) | ||
| <5000 | 125 | 31.4 |
| 5000–10,000 | 155 | 38.9 |
| >10,000 | 118 | 29.6 |
| BMI | ||
| <18 | 39 | 9.8 |
| 18–24.9 | 135 | 34.1 |
| 25–30 | 101 | 25.5 |
| 30–35 | 67 | 16.9 |
| >35 | 54 | 13.6 |
| Family member working in healthcare | ||
| No | 229 | 57.5 |
| Yes | 169 | 42.5 |
| Diabetes mellitus history | ||
| No | 355 | 89.2 |
| Yes | 43 | 10.8 |
| N | % | |
|---|---|---|
| Did you hear before about GLP-1 enhancer | ||
| No | 109 | 27.4 |
| Yes | 289 | 72.6 |
| Saxenda | ||
| No | 330 | 82.9 |
| Yes | 68 | 17.1 |
| Mounjaro | ||
| No | 136 | 34.2 |
| Yes | 262 | 65.8 |
| Ozempic | ||
| No | 161 | 40.5 |
| Yes | 237 | 59.5 |
| N | % | |
|---|---|---|
| Source of information | ||
| Social media | ||
| No | 171 | 43 |
| Yes | 227 | 57 |
| Internet | ||
| No | 324 | 81.4 |
| Yes | 74 | 18.6 |
| Healthcare professional | ||
| No | 293 | 73.6 |
| Yes | 105 | 26.4 |
| Television | ||
| No | 368 | 92.5 |
| Yes | 30 | 7.5 |
| Friends and family | ||
| No | 245 | 61.6 |
| Yes | 153 | 38.4 |
| I didn't hear it before | ||
| No | 344 | 86.4 |
| Yes | 54 | 13.6 |
| Uses of GLP-1 enhancer | ||
| Reducing weight | ||
| No | 78 | 19.6 |
| Yes | 319 | 80.4 |
| Glucose control | ||
| No | 186 | 46.7 |
| Yes | 212 | 53.3 |
| Reducing risk of obesity disease | ||
| No | 281 | 70.6 |
| Yes | 117 | 29.4 |
| Kidney | ||
| No | 22 | 100 |
| Yes | 0 | 0 |
| Cardiovasular System | ||
| No | 397 | 99.7 |
| Yes | 1 | 0.3 |
| Side-effect | ||
| Loss of appetite | ||
| No | 122 | 30.7 |
| Yes | 276 | 69.3 |
| Constipation | ||
| No | 275 | 69.1 |
| Yes | 123 | 30.9 |
| Diarrhea | ||
| No | 277 | 69.6 |
| Yes | 121 | 30.4 |
| Abdominal pain | ||
| No | 210 | 52.8 |
| Yes | 188 | 47.2 |
| Vomiting | ||
| No | 202 | 50.8 |
| Yes | 196 | 49.2 |
| Headache | ||
| No | 232 | 58.3 |
| Yes | 166 | 41.7 |
| Contraindications | ||
| Diabetes mellitus | ||
| No | 341 | 85.7 |
| Yes | 57 | 14.3 |
| Pregnancy and lactation | ||
| No | 103 | 25.9 |
| Yes | 295 | 74.1 |
| Children | ||
| No | 194 | 48.7 |
| Yes | 204 | 51.3 |
| Stomach | ||
| No | 216 | 54.3 |
| Yes | 182 | 45.7 |
| Pancreatitis | ||
| No | 221 | 55.5 |
| Yes | 177 | 44.5 |
| Kidney | ||
| No | 227 | 57 |
| Yes | 171 | 43 |
| Heart | ||
| No | 265 | 66.6 |
| Yes | 133 | 33.4 |
| N | % | |
|---|---|---|
| I am fully aware of GLP-1 enzyme enhancers from the stomach and their uses. | ||
| Not agreed | 223 | 56 |
| Agreed | 175 | 44 |
| I believe that GLP-1 enzyme enhancers from the stomach are effective only for treating obesity. | ||
| Not agreed | 258 | 64.8 |
| Agreed | 140 | 35.2 |
| I am aware of the potential side effects of these medications. | ||
| Not agreed | 126 | 31.7 |
| Agreed | 272 | 68.3 |
| I trust the information I receive about GLP-1 enzyme enhancers from my healthcare provider (pharmacist, doctor, etc). | ||
| Not agreed | 86 | 21.6 |
| Agreed | 312 | 78.4 |
| I feel confident in my ability to adhere to the treatment plan for GLP-1 enzyme enhancers. | ||
| Not agreed | 159 | 39.9 |
| Agreed | 239 | 60.1 |
| Regular follow-up appointments are important for managing my treatment with GLP-1 enzyme enhancers. | ||
| Not agreed | 101 | 25.4 |
| Agreed | 297 | 74.6 |
| I have concerns about the safety of GLP-1 enzyme enhancers. | ||
| Not agreed | 98 | 24.6 |
| Agreed | 300 | 75.4 |
| I have thoroughly researched GLP-1 enzyme enhancers before starting the treatment plan or using them for obesity management. | ||
| Not agreed | 182 | 45.7 |
| Agreed | 216 | 54.3 |
| OR (95% CI) | -valueP | |
|---|---|---|
| Age | ||
| <18 | Reference | |
| 19–39 | 0.54 (0.07–4.22) | 0.559 |
| 40–59 | 0.12 (0.01–2.01) | 0.139 |
| 60–64 | 0.31 (0.02–5.23) | 0.417 |
| Gender | ||
| Female | Reference | |
| Male | 0.53 (0.12–2.39) | 0.408 |
| Education level | ||
| Less than high school | Reference | |
| High school | 1.50 (0.10–22.04) | 0.768 |
| Bachelor | 1.05 (0.06–17.21) | 0.971 |
| Higher than Bachelor | 0.80 (0.02–27.33) | 0.904 |
| Income | ||
| <5000 | Reference | |
| 5000–10,000 | 0.18 (0.03–0.99) | 0.049 |
| >10,000 | 0.71 (0.14–3.75) | 0.69 |
| Family member in health system | ||
| No | Reference | |
| Yes | 3.04 (0.85–10.87) | 0.088 |
| Are you using or did you use | ||
| No | Reference | |
| Yes | 6.56 (1.82–23.66) | 0.004 |
| Constant | 0.04 (0.00–0.00) | 0.016 |
4. Discussion
The findings of this study provide significant insights into the awareness, usage patterns, side effects, and contraindications associated with GLP-1 RAs. A substantial proportion of participants (72.6%) reported having prior knowledge of GLP-1 enhancers, with Mounjaro being the most recognized drug (65.8%), followed by Ozempic (59.5%). On the other hand, Saxenda was the least familiar and relatively unknown (17.1%). This discrepancy reflects a variation in awareness among the overall population around particular GLP-1 RAs, perhaps due to marketing, physician advice, and online discussion. Findings are aligned with investigations proving variations in awareness based on media consumption and consultations with doctors.Various other research studies have established that newer agents, e.g., semaglutide, have been more favored in light of their demonstrated advantages in clinical trials and better weight loss performance. [,] 7 16 [,] 17 18
The most frequent reasons for using GLP-1 RAs among the participants were weight loss (80.4%) and control of blood sugar (53.3%), followed by a smaller group (29.4%) who said they used them to avoid obesity-related diseases. The findings align with previous studies that indicated GLP-1 RAs are prescribed primarily because of their action to reduce blood sugar and help with weight loss.Nonetheless, the proportionally lower percentage of patients using these drugs for obesity-related disease prevention indicates a shortfall in patient education on their general benefits beyond diabetes control. [] 5 [] 19
Side effects listed aligned with those reported during clinical trials. Most frequent adverse effects noted were loss of appetite (69.3%), vomiting (49.2%), and abdominal pain (47.2%). All such side effects that are gastrointestinal in origin are common and have been regarded by many as the chief determinant affecting patient compliance with the treatment.Psychiatric side effects such as mood change and depression were also reported and have raised concerns in recent research. These are especially prevalent with Ozempic (semaglutide), and point to the need for further study. [] 20 [] 21
Contraindications were also documented in bold, the highest frequency being pregnancy and lactation (74.1%), pediatric age group (51.3%), and kidney disease (43.0%). The findings concur with clinical practice recommendations that contraindicate the use of GLP-1 RAs in such groups due to safety concerns.More recent meta-analyses demonstrate that GLP-1 RAs have protective renal effects in diabetes patients, and contraindications should therefore be assessed individually. [] 22 [] 23
The study also identified a strong association between levels of knowledge and demographic factors. Of particular concern was that participants within the income group of 5000-10,000 SAR were identified as having significantly lower knowledge levels about GLP-1 enhancers compared to participants whose income level was <5000 SAR (OR = 0.18, 95% CI: 0.03–0.99, = .04). The negative association could be a sign of disparities in access to health information or differences in the patterns of health information seeking across income levels. This could be due to the heavy exposure to diabetes education in the public healthcare centers compared to the private sector.Further, multiple factors might affect GLP-1 RAs-related knowledge, such as education level, disease duration, and participants' self-management behavior.This was confirmed by multiple studies from Saudi Arabia, which showed that information sources and education level were important predictors of diabetes knowledge. Previous studies showed that social media platforms have improved public awareness of GLP-1 RAs as a first-line treatment for obesity, with demonstrated effectiveness in weight loss.This could have led to the better awareness and comprehension related to these medications. P [,] 24 25 [] 26 [] 27
Previous research has also indicated socioeconomic factors as being determinative in medication awareness and availability.Patients who were previous users or were currently using GLP-1 RAs were also much more likely to have enhanced knowledge about these medications (OR = 6.56, 95% CI: 1.82–23.66, = .004). This discovery points toward the increased experience with the drugs being associated with higher experience of their impact, use, and risk factor awareness, signifying the presence of experiential learning as part of medical literacy. These observations emphasize the need for educational interventions through proper educational strategies, ensuring that understanding and awareness with respect to GLP-1 RAs increase, especially within lower socioeconomic groups, as well as patients without prior experience of these medicines. [] 28 P
Public initiatives are needed to expand medical education within healthcare settings, including public and private healthcare settings. Educational initiatives and campaigns should target healthcare providers and diabetic patients. These campaigns should clarify disease misinformation. Decision makers should regulate the use of GLP-1 RAs at the national level to promote the safe and effective usage of these medications.
Healthcare providers must employ varied means of communication, such as social media, to offer accurate and sufficient information about GLP-1 receptor agonists so that patients can take informed decisions for themselves. Later studies can investigate other determinants influencing public knowledge and perception, such as healthcare provider advice, cultural determinants, and patients' use of digital health resources. Moreover, further research must investigate the long-term compliance problems of GLP-1 RAs and potential ways to enhance patient retention and treatment success.
This study has limitations. The use of an online survey study design and recruiting the participants using a convenience sampling technique might have affected the generalizability of the study findings. This methodological approach might only represent participants who have access to online platforms. However, due to the widespread use of social media platforms in Saudi Arabia across all demographic groups, we expect that the impact of this methodological approach on the generalizability of our findings is minimal. Therefore, the study findings should be interpreted carefully.
5. Conclusion
The findings of this study indicate that participants have a moderate to high level of awareness of GLP-1 enhancers, with Mounjaro being the most well-known brand and social media serving as the primary source of information. The majority of individuals reported that they used these medications predominantly for weight reduction, and they frequently experienced side effects such as abdominal pain, vomiting, and appetite loss. Notably, individuals in lower income brackets exhibited substantially better knowledge of GLP-1 enhancers than those in higher income brackets, while prior or current users exhibited the highest levels of awareness, highlighting the important role of clinical exposure. Future research should investigate the fundamental causes of income-related disparities in knowledge and evaluate the effectiveness of social media as an educational resource. Moreover, future research should examine the impact of educational interventions on participants' awareness and safety perceptions. Furthermore, longitudinal studies are required to assess the long-term safety, efficacy, and awareness of GLP-1 enhancers in a variety of populations.
Author contributions
Amal Khaleel AbuAlhommos. Conceptualization:
Amal Khaleel AbuAlhommos. Data curation:
Amal Khaleel AbuAlhommos. Formal analysis:
Amal Khaleel AbuAlhommos. Funding acquisition:
Amal Khaleel AbuAlhommos, Maitham Abdullah Al Hawaj, Sharifa Yousef Alrasheed, Reem Abdulrahman Alessa, Alzahra Yousef Alhussain, Rouaa Adel Alabdulkareem, Raghad Ibrahim Abdulaziz Alzamil. Investigation:
Amal Khaleel AbuAlhommos. Methodology:
Amal Khaleel AbuAlhommos, Maitham Abdullah Al Hawaj. Project administration:
Amal Khaleel AbuAlhommos, Maitham Abdullah Al Hawaj, Sharifa Yousef Alrasheed, Reem Abdulrahman Alessa, Alzahra Yousef Alhussain, Rouaa Adel Alabdulkareem, Raghad Ibrahim Abdulaziz Alzamil. Resources:
Amal Khaleel AbuAlhommos. Software:
Amal Khaleel AbuAlhommos. Supervision:
Amal Khaleel AbuAlhommos. Validation:
Amal Khaleel AbuAlhommos. Visualization:
Amal Khaleel AbuAlhommos. Writing – original draft:
Amal Khaleel AbuAlhommos, Maitham Abdullah Al Hawaj, Sharifa Yousef Alrasheed, Reem Abdulrahman Alessa, Alzahra Yousef Alhussain, Rouaa Adel Alabdulkareem, Raghad Ibrahim Abdulaziz Alzamil. Writing – review & editing: