GPs' perspectives on GLP-1RAs for obesity management: a qualitative study in England.

Abstract

Effective treatments are needed for the increasing number of people living with obesity. GPs are key in managing obesity within the NHS but report low confidence in available treatment options. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown promise in weight management, but at the time of this study lacked commissioned primary care service pathways for this indication. To explore the perspectives of NHS GPs in England on GLP-1RAs and their integration into primary care for weight management. In this qualitative study, participants were GPs practising in England, recruited through purposive sampling to reflect diverse geographical and socioeconomic contexts. Twenty-five semi-structured interviews, which were conducted April-July 2024, were thematically analysed. Participants generally held positive views about the implementation of GLP-1RAs for weight management in primary care; however, this was joined by hesitations about resource limitations. Navigating consultations with patients asking for prescriptions, or support with private use, often posed difficulties. Concerns included that GLP-1RAs could detract from tackling the broader determinants of obesity. Participants also worried that the medications could be misused, ultimately becoming an overly simplistic solution for patients, practitioners, and the wider health system. Our findings suggest that while GPs view GLP-1RA integration as a valuable therapeutic option for primary care obesity management, they have concerns about this being done well. To strengthen GP support for implementation, it is essential to recognise the need for adequate resources and ensure that GLP-1RAs are integrated into a holistic strategy for addressing obesity.