Background: Glucagon-like peptide-1 receptor agonists (GLP-1RA) are an effective weight management treatment but are expensive with limited government subsidisation for individuals with obesity and access largely restricted to costly private prescriptions. Concerns exist about equitable access, affordability, and adequacy of supportive care. This research explored Australian GLP-1RA medication use, focusing on usage barriers and support systems to inform strategies for safe and improved access for individuals with obesity without diabetes.
Methods: A cross-sectional survey online survey was used to collect a convenience sample of participants via Facebook/Instagram. Participants were asked about patterns of weight loss injection usage and support accessed while using the medications. Eligibility included living in Australia and aged >18 years old. Key variables measured included demographics, access to medications, prescribing practitioner and self-reported perceptions of nutritional, physical activity, and behavioural support. Data were descriptively analysed and univariate logistic regression used to identify factors associated with perceptions of support.
Results: N = 1311. The sample was predominantly female (90.1%), English-speaking (95.5%), with participants evenly distributed across socioeconomic quintiles. Most participants (72.9%) had obesity, with 58.1% reporting current GLP-1RA use (mainly semaglutide 55.9%), predominantly prescribed by GPs. Affordability was a significant barrier with 58.3% of users finding GLP-1RA ‘difficult/very difficult’ to afford. Despite clinical guidance promoting multidisciplinary support, several support gaps were identified: only 44% received sufficient dietary support, 36% physical activity support and 34% behavioural/psychological support. Only 22.6% reported referral to other healthcare professionals (mostly dietitians). Greater need for support was reported by those with higher obesity classes and lower socioeconomic status.
Conclusion: GLP-1RA use for obesity appears to be widespread, but high cost and under-provision of multidisciplinary support underscore significant equity and sustainability challenges. Support needs of users are not being adequately met, indicating urgent need for integrated, patient-centred approaches to improve access and health outcomes.