Analyzing postpartum patients' attitudes towards medication for weight management: a mixed-methods analysis

Pregnancy and the postpartum period present unique stressors that can be barriers to weight loss efforts. The landscape of weight management is rapidly evolving, but without specific understanding or consideration of postpartum people's needs and attitudes towards newer pharmaceutical options (e.g., GLP-1 agonists). We aim to characterize postpartum people's perspectives on weight management interventions in the weeks to months following birth. This study assesses the attitudes of postpartum people with a BMI >30 kg/m2 towards weight management in the immediate postpartum period.

This was a prospective, observational study leveraging mixed-methods techniques to extract the opinions and stances of postpartum people from a single institution with a BMI >30 kg/m2 via semi-structured interviews. A total of three focus groups and two one-on-one interviews were conducted. Thematic qualitative analysis was performed to identify emergent themes, followed by a sentiment analysis to quantitatively compare the emotive lexical context of each major theme.

We qualitatively identified four major themes during the interviews: attitudes about medication ("Medication"), attitudes towards and experiences with weight fluctuation ("Weight"), tools for losing weight ("Tools"), and concerns about long-term health ("Concern"). Quantitatively, participant statements about "Tools" were the most positive, with polarity scores (0.33 ± 0.27), while sentences related to "Concern" were the most negative (polarity scores 0.02 ± 0.25). Terms representing the emotions "joy," "anticipation," and "trust" were notably overrepresented compared to other emotions in sentences categorized as discussing "Tools." These positive stances were reaffirmed in our qualitative review, though participants were skeptical regarding the implications of weight loss medications on breastfeeding. They also conveyed concern about short-term use of medications, favoring a sustainable multimodal approach. Overall, participants expressed overwhelmingly positive attitudes towards weight management interventions in the postpartum period, specifically in conjunction with other lifestyle adjustments and support from medical and familial outlets.

In semi-structured interviews, postpartum participants with a BMI >30 kg/m2 favored a comprehensive plan for weight loss and management-including pharmacologic interventions and social supports or lifestyle alterations-starting in the weeks to months postpartum. Though they highlighted lingering concerns regarding safety and efficacy of pharmacologic interventions in this context, participants were open to integrating medications as one of many tools to optimize long-term cardiometabolic well-being.