BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have significantly influenced contemporary obesity pharmacotherapy, emerging as a major development in obesity care. Rising visibility in public discourse, healthcare practice, and commercial markets highlights the need to understand how these medications are accessed and experienced outside controlled experimental studies. Despite widespread use, real-world patterns of engagement, motivations, and concerns remain poorly understood amid high discontinuation rates, substantial and accelerated weight regain following cessation compared to traditional weight management intervention, and the potential for reduced effectiveness outside of the controlled setting of clinical trials. This study is the first to explore public perceptions, attitudes, and lived experiences of GLP-1RA use among UK adults, with attention to age, sex, BMI and use duration-specific responses.
METHODS: A cross-sectional design was employed using a self-administered online survey (n = 684), including 544 current or former GLP-1RA users. The survey captured demographic characteristics, health status, medication use, satisfaction, side effects, and body image.
RESULTS: Findings showed high satisfaction with GLP-1RA use, however effects on perceived energy, dietary habits, and concerns about a reduction in muscle mass were reported, with age and BMI influencing these experiences. Most users sourced medication from online pharmacies, reporting inconsistent pre-assessment rigour. Social media was the dominant information source, while healthcare professionals were less frequently consulted. A minority of users reported behaviours suggestive of misuse, including exceeding recommended doses, often driven by perceived inefficacy. Non-users expressed conditional willingness to adopt GLP-1RAs, influenced by clinical recommendation and stronger evidence, though concerns about side effects and long-term safety were prevalent.
CONCLUSION: This study suggests potential implications for regulatory strategy and highlights a need for targeted education and integrated behavioural support, particularly in light of reported rapid weight regain and reversal of beneficial effects on cardiometabolic markers following medication cessation. These results also provide important insights into demographic-specific experiences and provide important considerations to aid development of holistic, evidence-informed strategies to ensure safe and effective GLP-1RA use.
