The ubiquity of GLP-1 agonists in popular culture may be negatively affecting patients’ perceptions and use of the medications for weight management, according to a new survey of doctors around the world.
Sermo queried more than 1,150 healthcare providers for the latest edition of its “Barometer” report and found that nearly 80% believe the way in which Hollywood, celebrities and influencers have heartily embraced GLP-1s as a weight-loss tool “has harmed patients’ realistic expectations of the medication.”
These medications include licensed anti-obesity drugs from Novo Nordisk and Eli Lilly in the form of Wegovy and Zepbound, respectively, though some are also using diabetes meds like Novo's Ozempic and Lilly's Mounjaro, which use the same ingredient as their obesity counterparts, for weight loss.
Similarly, 72% of the doctors surveyed find it problematic that patients can be prescribed weight-loss medications via nontraditional settings like med spas and telehealth platforms, citing deficits in patient education, patient monitoring and knowledge of possible side effects. Those issues are top of mind for many doctors, as nearly 60% said they’ve recently made changes in their practices to monitor patients more closely amid reports of severe side effects possibly linked to GLP-1s.
Among those who are actively prescribing weight-loss medications to their patients, three-quarters said they’ve received reports of side effects, led by nausea, diarrhea and stomach pain—though only 20% of those active prescribers said they’ve had patients stop taking the medications due to side effects.
In another nontraditional turn for medication management, recent reports have found that some patients are “microdosing” GLP-1s in unapproved smaller amounts to mitigate side effects and make the expensive drugs last longer, often without doctor supervision or sign-off; more than 90% of the doctors surveyed by Sermo said they’re at least “somewhat” concerned about this trend.
Despite those potentially troubling effects of the drugs’ widespread popularity, the surveyed healthcare professionals remain enthusiastic about GLP-1 agonists’ future.
Indeed, they offered several suggestions for future expansions to the drugs’ labels. The most commonly wished-for indication was sleep apnea, with 57% of doctors expressing interest, followed closely by chronic heart failure, which 56% said they’d like to see included in the medications’ approvals. Other desired indications included metabolic dysfunction-associated steatohepatitis, or MASH, and chronic kidney disease.
As for what form that expanded drug class may take, most of the doctors told Sermo that an oral version is preferable: Almost 80% said they think most of their patients would choose to switch to an oral GLP-1 medication once widely available. An oral GLP-1 is, in fact, already available—Novo's Rybelsus, which is approved for Type 2 diabetes—but those specifically approved for weight management are still largely formulated as subcutaneous injections. Rybelsus is in trials to become an oral GLP-1 for obesity, though does not yet have an FDA approval in that setting.
“The expanding role of GLP-1 medications beyond weight loss, such as their potential to treat conditions like sleep apnea or chronic heart failure, represents an exciting shift in healthcare. For primary [and] family care, this evolution offers immense potential to address complex, interrelated conditions more effectively,” Kyle Lee, an academic family physician and member of Sermo’s medical advisory board, said in a statement.
However, he added, “it also underscores the need for comprehensive training and systems to support safe prescribing practices and close patient monitoring. As these therapies evolve, primary care will be at the forefront of integrating them into holistic, patient-centered management.”