Real-world tirzepatide users prioritize health, report high ease of use despite cost barriers

Despite the proven efficacy of tirzepatide in clinical trials like SURMOUNT for significant weight reduction and improved health-related quality of life (HRQoL) in individuals with obesity or overweight, there remains a critical gap in understanding real-world patient experiences. Specifically, the motivators and barriers to initiating tirzepatide, as well as the practical ease of use, have been underexplored outside of controlled trial settings. This real-world perspective is crucial for informing patient counseling, addressing access challenges, and optimizing adherence to obesity medication (OM) therapies.

This descriptive, real-world, observational study, known as the PERCEPTIONS survey, collected baseline data from 518 adults in the US between June and November 2025. Participants were eligible for obesity medication, had obesity (BMI ≥30 kg/m2) or overweight (BMI ≥27 kg/m2 with ≥1 obesity-related complication), and did not have type 2 diabetes mellitus. The survey was completed within 4-8 weeks of the participants' first tirzepatide dose. Key questions focused on demographic and clinical characteristics, prior treatments, patient-reported outcomes, and, critically, motivators and barriers to treatment initiation, alongside the perceived ease of tirzepatide use.

The study included 518 participants (mean age: 46.0 years, 78.2% female, mean BMI: 38.4 kg/m2). The average time between the first tirzepatide dose and survey completion was approximately ~26 days. A significant majority, 89.2%, initiated tirzepatide at the 2.5 mg dose, with 12.7% having previously used semaglutide. Nearly half of participants had struggled to achieve or maintain weight reduction through diet and exercise alone. Participants reported substantial impairments in physical functioning and psychosocial well-being at baseline, along with high internalized weight bias. Primary motivators for starting tirzepatide included improving overall health and well-being (83.8%), enhancing physical functioning (58.3%), and boosting self-confidence/appearance (51.4%). However, significant barriers were identified: concerns about treatment cost (57.7%) and health insurance coverage (90%).