Semaglutide and Tirzepatide Satisfaction Driven by Side Effect Reduction, Satiety, Mood, and Activity, Not Just Weight Loss
Background
While incretin-based therapies like GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists have shown significant efficacy in weight management for obesity and overweight with comorbidities, real-world patient experience often presents challenges related to tolerability and treatment continuation. The specific determinants of patient satisfaction extend beyond mere weight loss, and understanding these factors is crucial for optimizing long-term adherence and improving overall patient outcomes in chronic conditions like obesity.
Study Design
A cross-sectional online survey was conducted between January and February 2025 among international incretin therapy communities. The study enrolled 411 adults with obesity (BMI ≥30 kg/m²) or overweight with comorbidities (BMI 27-29.9 kg/m²) who had been receiving semaglutide or tirzepatide for at least 3 months. Treatment satisfaction was rigorously assessed using the validated Treatment-Related Impact Measure-Weight (TRIM-Weight) questionnaire. Patient-reported outcomes, including changes in appetite regulation, mood, physical activity, sexual health, self-image, and social experiences, were evaluated using 5-point Likert scales.
Results
Participants had a median age of 39 years (IQR 33-47), with 71.8% being female, and a median treatment duration of 10 months (IQR 7-13). Notably, 34.3% reported treatment for ≥12 months. Univariate analyses revealed that higher treatment satisfaction was significantly associated with improvements across multiple domains, including appetite regulation, mood, physical activity, sexual satisfaction, self-image, positive social feedback, and fewer limitations due to side effects (all p < 0.05).
In fully adjusted multivariable models, several factors remained independently associated with higher
TRIM-Weightscores: fewer limitations due to side effects (β = 1.41; 95% CI 0.25-2.88), increased satiety (β = 0.68; 95% CI 0.10-1.29), improved mood (β = 0.69; 95% CI 0.19-1.28), and higher physical activity (β = 0.58; 95% CI 0.10-1.17). While greater BMI reduction initially showed an association with higher satisfaction in individually adjusted models, this link was attenuated and no longer statistically significant in the comprehensive fully adjusted model.
Key Findings
- Fewer side effect limitations independently predicted higher treatment satisfaction (β = 1.41).
- Increased satiety was a significant independent predictor of higher satisfaction (β = 0.68).
- Improved mood independently correlated with greater treatment satisfaction (β = 0.69).
- Higher physical activity independently contributed to increased treatment satisfaction (β = 0.58).
- BMI reduction was not a statistically significant predictor of satisfaction in fully adjusted models.
Why It Matters
This study shifts the focus from purely weight loss to a more holistic view of patient satisfaction with incretin therapies. Clinicians should emphasize broader benefits like improved mood, satiety, and physical activity, alongside side effect management, when counseling patients on semaglutide and tirzepatide. For individuals using these peptides, understanding that satisfaction stems from a constellation of factors beyond just the number on the scale can help manage expectations and improve adherence. This suggests that optimizing the patient experience involves not just dose titration for weight loss, but also proactive strategies to mitigate side effects and support improvements in daily functioning and well-being.
semaglutide
tirzepatide
obesity
patient-satisfaction
incretin
glp-1-agonist