Pre-Treatment Concerns and Their Association With Functioning and Well-Being During Incretin-Based Therapy: A Cross-Sectional Study.

AIM: This study aims to examine weight-loss history and pre-treatment concerns, and their associations with current functioning and well-being in adults undergoing incretin-based pharmacotherapy for obesity. MATERIALS AND METHODS: This cross-sectional study analysed 411 adults treated with three different incretin-based medications. Demographics, previous weight-loss interventions, barriers to earlier attempts, reasons for initiating incretin therapy, treatment characteristics and Treatment-Related Impact Measure for Weight (TRIM-Weight) total scores were assessed. Associations between specific pre-treatment concerns and functioning and well-being were analysed using univariate models and a multivariable regression model that adjusted for treatment related variables. RESULTS: Participants had a median age of 39 years (IQR 33-47), 79.1% were women, and the median BMI was 36.3 kg/m (IQR 32.2-42.3). The median TRIM-Weight total score was 68.2 (IQR 64.0-73.4). Most respondents (95.1%) had attempted weight loss, typically through combined diet and physical activity (71.8%), intermittent fasting (69.6%) and digital tracking tools (65.7%). In fully adjusted models, fear of side effects (β = -3.53, 95% CI -4.05 to -3.01), concerns about cost (β = -0.92, 95% CI -1.37 to -0.47) and injection anxiety (β = -0.67, 95% CI -1.16 to -0.18) were associated with lower functioning and well-being. Doubts regarding effectiveness showed a small positive association (β = 0.61, 95% CI 0.03-1.19). CONCLUSION: Among retrospectively reported pre-treatment concerns, fear of side effects, treatment costs and injection anxiety were most strongly associated with lower functioning and well-being, whereas moral or psychosocial concerns showed no independent associations after multivariable adjustment.