Preferences for Obesity Medications Among People With Overweight or Obesity in the United States: A Discrete-Choice Experiment (OPTIC).
Abstract
Aims
To evaluate the relative importance of attributes driving obesity medication (OM) choice and preferences among individuals with overweight or obesity.
Materials And Methods
US adults with obesity or overweight and ≥ 1 obesity-related complication completed an online survey including a discrete-choice experiment (DCE) in October-November 2025. In the DCE, participants chose between 2 hypothetical, experimentally designed OM profiles with attributes/levels related to efficacy, cardiovascular (CV) risk reduction, side effects, administration (route/frequency), and dosing instruction requirements. In a fixed-choice comparison, participants chose between 2 predefined oral OM profiles. Relative preference weights for the DCE attribute levels were estimated using a random-parameters logit model to estimate attribute importance, tradeoffs, and predicted treatment choice.
Results
Among 800 participants (400 OM-naïve/400 OM-experienced, 400 injection-naïve/400 injection-experienced), the most important attributes were route of administration, average weight-loss percentage, CV risk reduction, and the proportion of people achieving ≥ 20% weight loss. Dosing instructions had the lowest relative importance. There was a preference for 1 OM profile (Treatment A-a hypothetical oral semaglutide-like profile) over the alternative OM profile (Treatment B-a hypothetical orforglipron-like profile), according to the responses from the DCE (84.2% vs. 15.8%) and the fixed-choice question (90.0% vs. 10.0%). Only 23.4% indicated that taking an OM treatment on an empty stomach and waiting 30 min to eat would be disruptive to their lives. Most (73.3%) OM-naïve participants were open to taking an oral OM.
Conclusions
Individuals with overweight or obesity prioritise weight-loss efficacy, CV risk reduction, and oral administration in OM treatment decisions; dosing instruction requirements were of low importance.