Endocrine Abstracts

Introduction: The incidence of obesity is growing worldwide. Although lifestyle interventions form the cornerstone of treatment, their effectiveness and sustainability are often limited. In recent years, there has been growing interest in the use of glucagon-like peptide 1 receptor agonists (GLP1-RAs) for weight loss, since their effectiveness and safety are now well-established. Although general practitioners (GPs) are increasingly receiving questions about these medications, uniform guidelines on their use in primary care are lacking. Moreover, differences exist between guideline-based indications and reimbursement criteria, which may form an additional barrier. In this context, the present study aimed to investigate the experiences and perspectives of Flemish GPs regarding the use of GLP1-RAs for overweight and obesity in primary care.

Methods: We developed an online questionnaire using the Qualtrics platform. The survey was distributed to Flemish GPs between August 20, 2024 and December 29, 2024 and was anonymously filled in by 102 GPs. The results were descriptively analyzed, and statistical tests were performed using SPSS to explore associations between certain variables.

Results: Whereas a majority (96%) of Flemish GPs are willing to manage follow-up for patients on GLP-1 agonists, only one-third are comfortable initiating treatment. While some GPs see potential in these agents for preventing weight-related comorbidities or as a bridge to bariatric surgery, hesitations persist. Concerns include long-term safety and effectiveness, cost, limited availability, and the risk of undermining lifestyle changes. Some physicians also report feeling pressured by patients to prescribe these medications.

Conclusion: GLP-1 receptor agonists may be integrated into a multimodal strategy for treating overweight and obesity, when they are combined with lifestyle changes. Many GPs emphasized the importance of lifestyle interventions, even when prescribing GLP-1 agents. Future efforts should focus on a multidisciplinary approach that supports this treatment model from various perspectives, while also considering financial implications for the patients. The diversity of opinions among GPs underlines the need for clear, evidence-based guidelines in primary care, particularly regarding indications. These guidelines should be regularly updated because of rapid developments in this field.

Keywords: GLP-1 receptor agonists, weight loss, obesity, primary health care