Perceived Competence and GLP-1RA Weight Management Engagement: Mixed-Methods Insights From Six Patient Groups.

OBJECTIVE: This study aimed to explore patients' perspectives on GLP-1 receptor agonists (GLP-1RAs) for weight loss across the continuum of contemplating use to discontinuation, with and without achieving weight loss goals. METHODS: From June to October 2025, participants completed a 30-item survey and ~30-question semi-structured interview regarding their perceptions of GLP-1RAs for weight loss. Interviews were tailored to six GLP-1RA groups: (1) considering use; (2) < 3 months on therapy; (3) ≥ 3 months on therapy without achieving weight loss goal; (4) ≥ 3 months on therapy with achieving weight loss goal; (5) discontinued without achieving goal; and (6) discontinued after achieving goal. Qualitative coding and thematic analysis were conducted in Dedoose (9.0.107); quantitative analyses used SAS 9.4. RESULTS: A total of 185 participants consented, and 141 completed data collection (76%). Descriptive profiles suggested heterogeneity across psychosocial and behavioral domains. Groups 3 and 4 showed stronger profiles (higher perceived competence, intrinsic motivation, and self-monitoring). After false discovery rate adjustment across 78 comparisons, perceived competence was the only statistically significant differentiator: Group 1 was lower (z = -3.15; q = 0.0347) and Group 4 higher (z = 4.44; q < 0.001). CONCLUSIONS: Findings underscore the importance of tailoring behavioral support to individuals' stage of engagement in GLP-1RA-supported weight loss journeys.