ORIGINAL ARTICLE
Bali Medical Journal (Bali MedJ) 2025.
Volume 14.
Number 3 : 765-769 P-ISSN.
E-ISSN: 2302-2914
From miracle cure to misuse? The opportunities and challenges of glp-1 medications in the context of obesity stigma Department of Health Informatics.
College of Public Health and Health Informatics.
University of Hail.
Hail.
Saudi Arabia Department of Clinical Nutrition.
College of Applied Medical Sciences.
University of Hail (UOH).
Hail.
Saudi Arabia College of Pharmacy.
Qassim University.
Qassim.
Saudi Arabia Department of Clinical Pharmacy.
College of Pharmacy.
Taif University.
Taif.
Saudi Arabia College of Pharmacy.
King Faisal University.
Al-Ahsa.
Saudi Arabia College of Pharmacy.
Taif University.
Taif.
Saudi Arabia College of Pharmacy.
King Khalid University.
Abha.
Saudi Arabia Department of Clinical Pharmacy.
College of Pharmacy.
Taif University.
Taif.
Saudi Arabia Department of Pharmacy.
Mouwasat Hospital.
Dammam.
Saudi Arabia Department of Clinical Nutrition.
College of Applied Medical Sciences.
University of Hafr Al-Batin.
Hafr AlBatin.
Saudi Arabia College of Pharmacy.
King Saud University.
Riyadh.
Saudi Arabia College of Pharmacy.
University of Hafr Al-Batin.
Hafr Al-Batin.
Saudi Arabia Department of Pharmacy.
College of Pharmacy.
King Abdulaziz University.
Jeddah.
Saudi Arabia Department of Pharmaceutical Sciences.
College of Pharmacy.
Al Jouf University.
Al Jouf.
Saudi Arabia College of Pharmacy.
King Khalid University.
Abha.
Saudi Arabia Anas A.
Alhur1*.
Dalal Alanazi2.
Layan Alsadoon3.
Shoug Gary4.
Duaa Aljumaiah5.
Abdul-Majeed Al-Thubaiti6.
Khaled Nahari7.
Amal Adawi8.
Eman Alnahdi9.
Ghaliah Khalaf10.
Asma Almutairi11.
Zainab Alsheyokh12.
Ahad Bangitah13.
Marafi Alsabilah14.
Faisal Alshehri15 *Corresponding author:
Anas Ali Alhur.
Department of Health Informatics.
College of Public Health and Health Informatics.
University of HaAoil.
HaAoil.
Saudi Arabia.
alhur@gmail.
Received: 2025-10-10
Accepted: 2025-12-04
Published: 2025-12-31
INTRODUCTION
Obesity remains a major public-health concern worldwide and is strongly linked to chronic conditions such as diabetes and cardiovascular disease.
1,2 Although lifestyle modification is the first-line approach for weight control, many individuals struggle to achieve sustained improvement.
This challenge has contributed to increased ABSTRACT Background: GLP-1 receptor agonists have gained increasing attention for their effectiveness in weight management and diabetes treatment.
Their widespread use intersects with societal pressures related to body image and persistent obesity stigma, which may influence public perceptions and acceptance.
Understanding how knowledge, attitudes, and stigma interact is essential to support informed and appropriate use of GLP1 medications.
This study aimed to assess the opportunities and challenges of GLP-1 medication use within the context of obesity-related stigma in Saudi Arabia.
Methods: A cross-sectional online survey was conducted between January and March 2025 among adults in Saudi Arabia.
After excluding incomplete responses, data from 742 participants were analyzed.
The questionnaire collected information on sociodemographic characteristics, knowledge of GLP-1 medications, attitudes toward their use, and obesity stigma.
Reliability was assessed using CronbachAos alpha.
Statistical analyses included descriptive statistics.
Pearson correlation, independent t-tests, one-way ANOVA, and multiple linear regression, with statistical significance set at p < 0.
Results: Participants demonstrated relatively high knowledge of GLP-1 medications (M = 12.
SD = 2.
, while attitudes showed moderate variability (M = 10.
SD = 2.
Stigma scores were more widely distributed (M = 31.
SD = 3.
Knowledge was positively correlated with favorable attitudes toward GLP-1 use, whereas obesity stigma showed negative associations with both knowledge and attitudes.
Significant differences in attitudes were observed across gender, age, education level, and overweight or obesity diagnosis.
Regression analysis indicated that knowledge and stigma jointly explained 39% of the variance in attitudes, with higher knowledge predicting more positive attitudes and higher stigma predicting less favorable perceptions.
Conclusion: In conclusion, both knowledge and obesity stigma significantly influence public attitudes toward GLP-1 medications.
Enhancing public understanding while addressing weight-related stigma may foster more responsible, informed, and compassionate use of GLP-1 therapies in weight management care.
Keywords: GLP-1 receptor agonists, semaglutide, tirzepatide, obesity stigma, health behaviour.
Cite This Article: Alhur.
Abdullah.
Alsadoon.
Gary.
Aljumaiah.
Thubaiti.
Nahari.
Adawi.
Alnahdi.
Khalaf.
Almutairi.
Alsheyokh.
Bangitah.
Alsabilah.
Alshehri.
From miracle cure to misuse? The opportunities and challenges of glp-1 medications in the context of obesity stigma.
Bali Medical Journal 14.
: 765-769.
DOI: 10.
15562/bmj.
interest in medical therapies that provide more predictable outcomes.
Among these options.
GLP-1 receptor agonists, particularly semaglutide and tirzepatide, have gained significant attention for their ability to support weight reduction and improve glycemic Their clinical performance has led to rapid growth in public awareness and a perception that they represent a promising Open Bali Medical Journal 14.
: 765-769 | doi: 10.
15562/bmj.
therapeutic development in obesity care.
However, increased use has brought forward several concerns.
Social media promotion, expectations of rapid weight loss, and use outside approved indications have raised questions regarding safety, equitable access, and medication shortages for individuals who rely on GLP-1 agents for diabetes management.
ORIGINAL ARTICLE
These issues interact with another factor, including obesity stigma.
Individuals living with excess weight often face assumptions, criticism, and unfair treatment, which may discourage engagement with healthcare services and contribute to emotional Obesity stigma is defined as negative societal attitudes and beliefs directed toward individuals with excess weight, often grounded in the perception that obesity is primarily the result of personal responsibility rather than a complex, chronic disease influenced by biological, environmental, and social determinants.
such stigma has been consistently associated with discriminatory practices, suboptimal patientAeprovider interactions, and reduced utilization of healthcare 9 Within this context, the increasing visibility and use of GLP1 receptor agonists may constitute a double-edged While these medications have the potential to reinforce the conceptualisation of obesity as a medical condition and thereby mitigate moral blame, perceptions of pharmacological weight loss as a Aushortcut,Ay together with unequal access and high treatment costs, may perpetuate existing biases or contribute to the emergence of new forms of weight-related stigma.
Therefore, knowledge, attitudes, and weight-related beliefs influence perceptions of GLP-1 medications is essential.
By examining these elements together, this study aims to evaluate the opportunities and challenges of GLP-1 medications in the context of obesity stigma.
METHODS
Study Design and Setting This study used a cross-sectional survey design to evaluate public knowledge, attitudes, and stigma toward GLP1 medications.
The study population consisted of adults living in Saudi Arabia.
Data collection was conducted between January and March 2025 using an online questionnaire administered through Google Forms, allowing broad geographic coverage and efficient data acquisition.
Participants and Sampling A convenience sampling approach was Adults aged 18 years or older residing in Saudi Arabia were eligible to participate.
Participants were required to complete all core sections of the questionnaire assessing knowledge, attitudes, and obesity-related stigma toward GLP-1 medications.
Survey Instrument The survey instrument was created after a thorough examination of relevant literature and consisted of four major The first portion gathered sociodemographic information such as age, gender, region of residence, marital status, educational level, job status, and the existence of chronic illnesses.
The second section assessed participantsAo knowledge of GLP-1 medications, focusing on their purpose, indications, mechanism of action, benefits, and potential risks.
The third section explored attitudes toward GLP-1 medication use, including willingness to use the medication, perceived fairness, and concerns regarding misuse.
The fourth section evaluated obesity-related stigma using items adapted from established public stigma instruments and the Weight Bias Internalisation Scale.
The survey instrument was created after a thorough examination of relevant literature and consisted of four major elements.
The first portion gathered sociodemographic information such as age, gender, region of residence, marital status, educational level, job status, and the existence of chronic Inclusion and Exclusion Criteria Participants were eligible for inclusion if they were individuals aged 18 or older, lived in Saudi Arabia at the time of data collection, and gave electronic informed Eligible participants were required to complete all core sections of the questionnaire assessing knowledge, attitudes, and obesity-related stigma toward GLP-1 medications.
Participants were excluded if they were unable to read and understand Arabic.
Individuals with a self-reported diagnosis of type 1 diabetes were excluded due to differences in treatment indications and disease characteristics relative to the study focus.
Responses with missing or incomplete data in key study variables, including knowledge, attitude, or stigma scores, were also excluded from the final analysis.
Data Collection Procedure Participants accessed the survey over a secure internet connection.
The first page of the questionnaire included an electronic informed consent form that described the studyAos aims, voluntary participation, confidentiality of replies, and the possibility to withdraw at any moment without penalty.
Only participants who selected the AuAgreeAy option were allowed to advance with the questionnaire.
The average time to finish the survey was 8-10 Missing Data Handling All submitted responses were screened prior to analysis.
Participants with missing values in key analytical variables .
nowledge, attitude, or stigma total score.
were excluded using a listwise deletion approach, resulting in a final analytical sample of 742 participants.
Some sociodemographic variables contained occasional missing responses.
missing values for these variables are reported descriptively in Table 1.
All inferential analyses were conducted using the final analytical sample .
= .
imputation methods were applied.
Statistical analysis Statistical analyses were carried out using IBM SPSS Statistics version 29.
Descriptive statistics, such as frequencies, percentages, means, and standard deviations, were employed to summarise participant characteristics and primary research Composite scores for knowledge, attitudes, and stigma were calculated after reverse-coding negatively worded Differences in attitude ratings between two independent groups were investigated using independent samples t-tests, with WelchAos t-test used when the assumption of variance homogeneity was Group comparisons involving more than two categories, including age groups and education levels, were assessed using one-way analysis of variance.
Pearson correlation coefficients were used to investigate associations between knowledge, attitudes, and stigma.
Multiple linear regression analysis was used to determine predictors of attitudes regarding Bali Medical Journal 2025.
: 765-769 | doi: 10.
15562/bmj.
ORIGINAL ARTICLE
GLP-1 medicine usage, with knowledge and stigma serving as the key independent Statistical significance was determined at p < 0.
Potential Bias Several restrictions should be acknowledged when interpreting the results.
The practice of convenience sampling may lower the sampleAos representativeness and restrict generalizability to the larger population.
Additionally, data were collected through self-reported measures, which may be subject to information bias, including recall bias and socially desirable responding.
Table 1.
Sociodemographic Characteristics of Participants Variable Female Male 18Ae24 25Ae34 35Ae44 45Ae54 Ou55 High school or less Diploma BachelorAos degree Postgraduate (Master/PhD) Gender Age group .
Education level RESULTS A total of 742 participants were included in the final analysis after removing incomplete or invalid responses.
Table 1 presents the sociodemographic characteristics of the sample.
Slightly more than half of the respondents were female .
8%).
Most participants were between 25 and 34 years of age .
6%), and the majority held a bachelorAos degree .
4%).
About one-third reported having been diagnosed with overweight or obesity .
4%).
CronbachAos alpha values for the three domains demonstrated acceptable Knowledge ( = 0.
Attitude ( = 0.
, and Stigma ( = 0.
all exceeded the threshold for internal These values indicate that items within each domain measured their intended constructs consistently (Table .
Table 3 presents the descriptive statistics for knowledge, attitude, and stigma scores.
Knowledge scores showed a relatively high mean (M = 12.
= 2.
, indicating generally adequate understanding of GLP-1 medications among participants.
Attitude scores demonstrated moderate variability (M = 10.
SD = 2.
, while stigma scores exhibited wider dispersion (M = 14.
= 3.
, suggesting substantial variability in weight-related stigma perceptions.
Table 4 shows a moderate positive link between knowledge and attitudes toward GLP-1 usage .
= 0.
41, p < 0.
Higher levels of weight-related stigma were linked to lesser knowledge and less favourable views towards GLP-1 drugs .
= -0.
22, p < 001 and r = -0.
36, p < 0.
001, respectivel.
, showing a negative correlation.
Higher stigma scores indicated greater weight-related stigma and beliefs.
Group comparisons revealed several significant differences in attitude scores.
Participants diagnosed with overweight or obesity reported significantly more favourable attitudes toward GLP-1 medications compared with those without such a diagnosis (WelchAos t = Oe6.
12, p < 0.
Significant differences in attitudes were also observed across gender (WelchAos t = 49, p < 0.
, age groups (F.
= 7.
p < 0.
, and education levels (F.
= 27, p < 0.
, as shown in Table 5.
A multiple linear regression model was employed to investigate the determinants of opinions about GLP-1 medicines.
The model explained 39% of the variation in attitudes (RA = 0.
Knowledge was favourably linked with attitudes (B = 0.
p < 0.
, whereas stigma was negatively associated (B = -0.
20, p < 0.
These findings show that more understanding and less stigma are related to more positive attitudes toward GLP-1 treatment (Table Figure 1 illustrates the distribution of participant responses related to the main study constructs.
The overall pattern reflects variability in awareness levels, beliefs, and attitudes toward GLP-1 Table 2.
DISCUSSION