Preferences for Obesity Medications Among People With Overweight or Obesity in the United States: A Discrete-Choice Experiment (OPTIC).

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.