Understanding reasons for initiation and experience with tirzepatide among individuals with obesity or overweight: Results from the PERCEPTIONS survey.

BACKGROUND: Obesity contributes to multiple complications, increased mortality, and reduced health-related quality of life (HRQoL). Tirzepatide demonstrated sustained weight reduction and improvements in HRQoL in the SURMOUNT studies. Limited data are available regarding real-world experiences of participants initiating tirzepatide. METHODS: This manuscript reports baseline data from the PERCEPTIONS survey, a real-world, observational study conducted in the US (June-November 2025). The study enrolled obesity medication (OM)-eligible adults with obesity (BMI ≥30 kg/m) or overweight (BMI ≥27 kg/m with ≥1 obesity-related complication) and without type 2 diabetes mellitus. The survey was completed within 4-8 weeks of first tirzepatide dose. Questions included demographic and clinical characteristics, previous treatments, patient-reported outcomes, motivators/barriers to treatment initiation, and ease of tirzepatide use. RESULTS: The descriptive study included 518 participants (mean [SD] age: 46.0 [11.58] years, 78.2% female, 69.5% White, mean [SD] BMI: 38.4 [8.38] kg/m). The mean [SD] duration between the first tirzepatide dose and baseline survey completion was ∼26 (16) days; 89.2% initiated tirzepatide at 2.5 mg dose and 12.7% had previously received semaglutide. Nearly half had previously been unable to reduce weight/maintain weight reduction using exercise and dietary interventions. Participants reported substantial impairments in physical functioning, psychosocial well-being, and high internalized weight bias at tirzepatide initiation. Primary motivators for initiating tirzepatide included improving overall health and well-being (83.8%), physical functioning (58.3%), and self-confidence and/or appearance outside of work (51.4%). Common barriers to tirzepatide initiation included concerns about treatment cost (57.7%), and health insurance coverage (90%). Majority of auto-injector (98.0%) and vial users (95.8%) reported that tirzepatide was easy to use. CONCLUSIONS: This real-world survey emphasized the multifaceted disease burden experienced by participants with obesity or overweight. Participants initiating tirzepatide were highly motivated to lose weight, improve their well-being, and self-confidence. Identifying common barriers to OM access will help optimize health strategies for obesity management.