Semaglutide/Tirzepatide with Virtual Behavioral Support Significantly Improves Psychosocial Outcomes in Obesity Over 24 Weeks

Obesity is a complex chronic disease with significant psychosocial burdens, yet newer generation anti-obesity medications (AOMs) like semaglutide and tirzepatide, while highly efficacious for weight loss, often lack integrated behavioral support in real-world telehealth settings. Research on the impact of these incretin-based medications on crucial psychosocial variables like depression, stress, and quality of life remains limited. This study addresses the gap by evaluating a combined telemedicine and behavioral intervention approach.

This single-arm pragmatic trial recruited 180 participants (mean age 44.1; 91% female) from a telemedicine obesity program (WeightWatchers Clinic). Participants received semaglutide/tirzepatide (long-acting incretin therapy) alongside an adjunctive virtual behavioral program specifically designed for patients on these medications. Psychosocial outcomes were assessed at baseline, 12 weeks, and 24 weeks using validated instruments including the PHQ-8 (depression), Perceived Stress Scale, Self-Compassion Scale, WHO-5 (well-being), Weight Bias Internalization Scale-2F, and Impact of Weight on Quality of Life-Lite. Wilcoxon signed-rank tests with False Discovery Rate adjustment and Intent-to-treat analysis (using LOCF) were employed.

Significant improvements were observed across multiple psychosocial measures from baseline to 24 weeks. Participants experienced a median reduction of -2 in depression scores (PHQ-8), -3 in perceived stress, and -0.6 in weight bias internalization. Well-being scores (WHO-5) increased by 3, and the impact of weight on quality of life improved by -18. All these changes were statistically significant, with p < 0.001 in the baseline to 24-week analyses. Similar positive trends and significant results were also evident at the 12-week mark, indicating a sustained benefit of the combined intervention. The findings highlight the broad positive impact of integrating behavioral support with incretin-based AOMs on mental health and quality of life. This demonstrates the potential for a more holistic approach to obesity management.