Patient interviews help identify components to a successful GLP-1 weight-loss program

SAN ANTONIO — Patient interviews showed weight loss via GLP-1 receptor agonists is a major emotional journey, many have anxiety surrounding cessation and weight regain due to lack of access, a speaker reported.

Jenna M. Napoleone, PhD, MPH, senior clinical research scientist at Omada Health in San Francisco, and colleagues conducted patient and care team interviews to identify some of the most desired components of a successful GLP-1 lifestyle intervention program for weight loss and presented their results at ObesityWeek.

“I’m sure many of you ... are particularly aware of all of the exciting research that’s come out in the last several years on GLP-1s, and in particular the impressive health outcomes that people are able to achieve while on the medication,” Napoleone said during a presentation. “However, there’s also been some research that’s shown that maybe people are discontinuing the medication prior to being able to reap the benefits. We were particularly interested in understanding what real-world experiences that people have gone through, taking the medication and also discontinuation and understanding what works for people and what doesn’t work for people with these meds so that we can create interventions that are as effective as possible for long-term health outcomes.”

Napoleone and colleagues conducted a 12-week pilot study to evaluate demographics, clinical characteristics and experiences among 159 individuals without diabetes who were taking a GLP-1 receptor agonist and enrolled in either a weight management lifestyle intervention program or a hypertension program (mean age, 46 years; 87% women; 65% white; mean baseline BMI, 31.8 kg/m2).

This was a mixed-method study involving self-reported surveys and qualitative interviews before and after the 12-week intervention component of the study, which involved weekly outreach from a care team; educational materials about weight gain after GLP-1 discontinuation; and peer support.

Those eligible for the follow-up survey were enrolled in member interviews and care team focus groups to understand their experiences during the pilot program up to 12 weeks, according to the study.

Enrolled participants reported using a GLP-1 receptor agonist for at least 8 weeks and reported cessation within 4 weeks of receiving their eligibility survey, Napoleone said.

The average weight loss related to GLP-1 use was approximately 11.8% and the average time on a GLP-1 was 41 weeks. The most common GLP-1s used during a patient’s weight-loss journey were semaglutide (Wegovy, Novo Nordisk) and tirzepatide (Zepbound, Eli Lilly), with 81.8% and 35.2% using each, respectively, or together, according to the researchers.

After the qualitative interviews, Napoleone and colleagues reported observing the following themes surrounding GLP-1 cessation:

The researchers also conducted interviews of the care team, which highlighted the following themes:

In addition, Napoleone reported that patients said they felt that the GLP-1 receptor agonist was a “last resort.”

“The second theme that came out of the qualitative interviews is that GLP-1 are our last resort. What we mean by this is that these are members that have reported really trying everything up to this point, but not seeing that scale move. Not having any success with weight loss,” she said. “Whenever members were prescribed GLP-1s, this was meant with a sense of relief and a feeling like at for once they had the confidence that while they were taking their GLP-1, they might be able to better manage their weight and see the scale move.”

Issues with access to GLP-1 receptor agonists were also noted among respondents’ interviews as well as a comments on the nonlinear path to their use. Napoleon cited the drug shortages as a significant contributor to GLP-1 interruptions and discontinuation and reported that approximately 75% of discontinuations were due to issues with access to the drug.

“But we wanted to take it one step further and specifically ask people, what components would you want to have in a GLP-1 lifestyle intervention program to help you be as successful as possible,” she said.

The following program components were requested by the patients:

“Members also crave personalized and specialized content around how to be successful and conquer these long-term behavior change goals that they had in order to keep the weight off without a GLP-1,” Napoleone said.

Collapse

Napoleone JM. Oral-001. Presented at: ObesityWeek; Nov. 3-6, 2024; San Antonio.