A cross-sectional investigation conducted among 975 adult residents in the Aseer Region of Saudi Arabia revealed that while recognition of specific glucagon-like peptide-1 receptor agonists is relatively widespread, substantial deficits and misconceptions persist concerning their safety profiles, clinical indications, adverse effects, and monitoring requirements. The study, published in Frontiers in Public Health, evaluated community comprehension of these increasingly prominent pharmacological agents in the context of rising public interest in medical weight management. Excess body weight represents a documented public health concern within Saudi Arabia, where 2024 national figures indicated that 42.6 percent of individuals aged 15 years and older were classified as overweight and 23.1 percent were classified as obese. Although these therapies have demonstrated clinically meaningful weight reduction in systematic reviews and randomized controlled trials by promoting satiety, delaying gastric emptying, stimulating insulin secretion, and suppressing glucagon release, researchers found that general name recognition frequently failed to translate into comprehensive pharmacological understanding among surveyed adults.

The study protocol utilized an electronic questionnaire disseminated across online platforms, messaging networks, and physical community venues between June 5 and July 2026. Participant recruitment was conducted using convenience sampling of adults aged 18 years and older who were literate in Arabic and able to complete the survey independently. To establish sample size adequacy, the investigators carried out an a priori statistical calculation using the Raosoft calculator, determining that a minimum of 384 participants was necessary based on a 95 percent confidence level, a 5 percent margin of error, and an assumed 50 percent prevalence rate. A total of 992 responses were submitted, from which 17 were excluded due to lack of electronic consent or incomplete survey forms, yielding a final analytical sample of 975 valid records. Because distribution took place across multiple digital networks including WhatsApp, X, and Facebook, alongside on-site quick-response codes posted in public shopping malls and community gathering places, the absolute reach of the survey invitation could not be calculated, precluding the determination of a conventional response rate.

Demographic assessment of the 975 respondents demonstrated a balanced sex distribution, comprising 501 men representing 51.4 percent of the cohort and 474 women representing 48.6 percent. Participants were categorized into five age strata: 216 individuals aged 18 to 29 years representing 22.2 percent of the cohort, 195 individuals aged 30 to 39 years representing 20.0 percent, 237 individuals aged 40 to 49 years representing 24.3 percent, 183 individuals aged 50 to 59 years representing 18.8 percent, and 144 individuals aged 60 years or older representing 14.8 percent. Saudi nationals constituted 69.8 percent of respondents with 681 participants, while non-Saudi residents made up 30.2 percent with 294 individuals. Most respondents were married, accounting for 62.8 percent, and 39.4 percent held a university graduate degree. Regarding clinical profiles, body mass index classifications showed that 39.7 percent were overweight, 36.3 percent fell within normal weight parameters, 16.0 percent were classified as obese, and 8.0 percent were underweight. Additionally, 318 participants, or 32.6 percent, reported a medical history of diabetes mellitus.

Assessment of medication-specific familiarity showed that semaglutide was the most frequently recognized drug, identified by 576 individuals or 59.1 percent of the total sample. Tirzepatide followed with 510 participants or 52.3 percent reporting awareness, while liraglutide was recognized by 351 respondents representing 36.0 percent. When queried regarding the primary clinical indications of these medications, 507 participants, or 52.0 percent, correctly identified that GLP-1 receptor agonists are utilized for managing both diabetes and weight reduction. Meanwhile, 195 participants, or 20.0 percent, believed the medications were indicated solely for diabetes, 117 participants, or 12.0 percent, thought they were used exclusively for weight reduction, and 156 respondents, or 16.0 percent, indicated uncertainty. When evaluating where participants acquired information, informal networks and digital channels predominated: 630 respondents or 64.6 percent cited friends and family members, 567 or 58.2 percent cited social media platforms, and 537 or 55.1 percent cited general internet browsing. Direct medical communication was reported less frequently, with 501 individuals or 51.4 percent learning about the therapies from physicians and 495 or 50.8 percent from pharmacists, while 318 or 32.6 percent cited television broadcasts.

To evaluate participant knowledge, the researchers administered an 11-item true-false instrument addressing regulatory rules, administration safety, adverse physiological reactions, and clinical contraindications. The instrument exhibited robust internal consistency, yielding a Kuder-Richardson Formula 20 coefficient of 0.921, while construct validity was supported by exploratory factor analysis showing a Kaiser-Meyer-Olkin value of 0.931 and significant sphericity. Correct answers received one point, generating a possible score ranging from zero to 11. The sample achieved a mean knowledge score of 5.34 points with a standard deviation of 2.67 points and a median score of 5 points with an interquartile range of 4 to 7 points. Using the cohort median as a dichotomous cutoff threshold, 519 participants, or 53.2 percent, were categorized as possessing good knowledge, whereas 456 participants, or 46.8 percent, were categorized as having poor knowledge. While 54.2 percent correctly affirmed that GLP-1 receptor agonists require a formal medical prescription, only 59.7 percent recognized that unsupervised administration was unsafe, and substantial uncertainty persisted regarding gastrointestinal side effects such as nausea, vomiting, abdominal pain, diarrhea, and constipation.

Misconceptions surrounding clinical application and lifestyle integration were examined using a five-item scale demonstrating acceptable internal reliability, with a Cronbach alpha coefficient of 0.767. A substantial proportion of respondents endorsed inaccurate statements or expressed confusion about medical necessity. Notably, 219 individuals, or 22.5 percent, agreed that GLP-1 receptor agonists are completely safe for cosmetic weight management, while an additional 351 participants, or 36.0 percent, reported uncertainty regarding that statement. Furthermore, 153 participants, or 15.7 percent, believed that experiencing rapid weight loss signified that the drug was safe for universal use, with 279 respondents, or 28.6 percent, unsure. Regarding behavioral modification, 282 respondents, or 28.9 percent, agreed with the assertion that lifestyle alterations are less effective than pharmaceutical injections for weight loss, and 324 individuals, or 33.2 percent, were uncertain. Continuous use without ongoing clinical monitoring was endorsed by 111 participants, or 11.4 percent, with 279 individuals, or 28.6 percent, indicating they did not know whether periodic clinical oversight was required during treatment.

Bivariate statistical testing revealed that general knowledge scores were positively linked with specific familiarity regarding semaglutide. Respondents who were aware of semaglutide achieved a higher mean knowledge score than their unfamiliar peers, recording 6.34 points compared to 3.89 points, and demonstrated a higher rate of good knowledge categorization at 66.1 percent versus 34.6 percent, reflecting a statistically significant point-biserial correlation of 0.296. In unadjusted bivariate comparisons using Pearson chi-square tests, good overall knowledge displayed statistically significant associations with age, sex, marital status, nationality, educational attainment, occupational category, monthly household income, and body mass index, whereas diabetes diagnosis was not significant. Specifically, younger participants aged 18 to 29 years demonstrated the highest proportion of good knowledge, with 165 out of 216 individuals meeting the threshold, whereas older age categories exhibited larger proportions of poor knowledge, such as the 30 to 39 age group where 123 of 195 participants scored below the median cutoff.

Multivariable binary logistic regression was subsequently conducted to identify independent variables associated with good knowledge while adjusting for potential confounding factors. This adjusted model revealed that advancing age remained strongly and independently associated with lower odds of possessing good knowledge relative to the reference group of individuals aged 18 to 29 years. Specifically, participants aged 30 to 39 years had an adjusted odds ratio of 0.244 with a 95 percent confidence interval of 0.143 to 0.418, those aged 40 to 49 years exhibited an adjusted odds ratio of 0.361 with a 95 percent confidence interval of 0.207 to 0.629, those aged 50 to 59 years had an adjusted odds ratio of 0.351 with a 95 percent confidence interval of 0.195 to 0.630, and participants aged 60 years or older recorded an adjusted odds ratio of 0.283 with a 95 percent confidence interval of 0.157 to 0.512. Other factors independently associated with lower odds of good knowledge included non-Saudi nationality with an adjusted odds ratio of 0.593, non-healthcare employment with an adjusted odds ratio of 0.670, underweight status with an adjusted odds ratio of 0.316, and absence of diabetes with an adjusted odds ratio of 0.604. University graduates exhibited higher adjusted odds of good knowledge with an adjusted odds ratio of 1.642.

A separate multivariable logistic regression model examined factors independently associated with awareness of semaglutide. Age was again a significant factor, with older participants demonstrating diminished likelihood of awareness compared to the youngest cohort aged 18 to 29 years; respondents aged 60 years and older had an adjusted odds ratio of 0.145 with a 95 percent confidence interval of 0.078 to 0.270. Female sex was independently associated with nearly double the odds of semaglutide awareness compared to male sex, yielding an adjusted odds ratio of 1.973 with a 95 percent confidence interval of 1.452 to 2.679. Educational level also showed an independent effect, as university graduates had an adjusted odds ratio of 2.552 with a 95 percent confidence interval of 1.576 to 4.134 relative to participants with school-level education. Clinical factors played an additional role: obesity was associated with higher odds of awareness with an adjusted odds ratio of 2.762, underweight status was associated with reduced odds of awareness with an adjusted odds ratio of 0.332, and participants without a diabetes history showed lower adjusted odds of awareness with an adjusted odds ratio of 0.596 compared to those with diabetes.

The study authors highlighted several methodological limitations that contextualize these observational findings. Because the investigation employed a cross-sectional design, observed associations cannot establish longitudinal trajectories, directional causality, or temporal relationships between information exposure and participant comprehension. The application of non-probability convenience sampling and web-based recruitment may have introduced selection bias, potentially favoring individuals with higher digital literacy and regular internet access, while non-Arabic-speaking residents, older adults without digital access, and individuals with limited reading literacy were underrepresented. Furthermore, knowledge categories were established using an internal sample median rather than an external standardized diagnostic benchmark, and self-reported survey responses remain vulnerable to recall bias. In their discussion, the researchers concluded that the presence of high brand recognition alongside frequent confusion regarding contraindications, adverse reactions, and unsupervised use underscores an urgent requirement for targeted, evidence-based public health education and structured clinical counseling to ensure safe and appropriate therapeutic practices.

Subject of Research: Public awareness, knowledge, and misconceptions regarding GLP-1 receptor agonists for weight management among adults in Saudi Arabia

Article Title: Community awareness and misconceptions regarding GLP-1 receptor agonists for weight management among adults in the Aseer Region, Saudi Arabia: a cross-sectional study

Article References: Alshahrani, A. M., Kandasamy, G., Alharthi, S., Mani, V., & Prabahar, K. (2026). Community awareness and misconceptions regarding GLP-1 receptor agonists for weight management among adults in the Aseer Region, Saudi Arabia: a cross-sectional study. Frontiers in Public Health, 14, Article 1978025. https://doi.org/10.3389/fpubh.2026.1978025

Image Credits: AI Generated

DOI: 10.3389/fpubh.2026.1978025

Keywords: GLP-1 receptor agonists, semaglutide, public health, cross-sectional study, weight management, Saudi Arabia, Aseer Region, health education, Community, awareness, misconceptions, regarding