Exploring Adults' Experiences with Tirzepatide for Weight Loss: A Mixed-Methods Study

Background: Obesity confers substantial cardiometabolic risk. Tirzepatide, a once-weekly dual GIP/GLP-1 receptor agonist, produces dose-dependent weight loss in trials, but real-world patient-reported experiences are under-described. We evaluated real-world self-efficacy and experiences with tirzepatide in community settings. Methods: Explanatory sequential mixed-methods study of adults aged 18-59 years using tirzepatide for weight management. We collected a quantitative survey (demographics; medication use; 20-item Weight Efficacy Lifestyle Questionnaire [WEL]) followed by purposive semi-structured interviews. Associations between WEL and participant characteristics were tested a priori (two-tailed α = 0.05). Results: Among 120 participants (50.8% male; mean age 42 ± 13 years), 91.7% reported weight loss and 85.8% had <6 months' exposure. WEL total was 91 ± 34. Higher WEL was observed in females, employed participants, those with insurance coverage versus self-pay, during early months of therapy, and among those with prior weight-loss attempts (all p < 0.05). Interviews (n = 15) indicated high satisfaction, improved sleep/energy, mood, and confidence; gastrointestinal effects were usually mild/transient. Interpretation: In routine care, tirzepatide use was associated with high eating self-efficacy and positive patient-reported outcomes. Variation by coverage and duration suggests value in pairing pharmacotherapy with behavioral support and addressing affordability to sustain benefits.