A Cross-Sectional Survey of Sport Physicians' Perceptions of Glucagon-Like Peptide-1 Drug Use in Sport.

BACKGROUND AND OBJECTIVE: Anecdotal evidence suggests glucagon-like peptide-1 (GLP-1) drugs, typically prescribed to manage diabetes mellitus and assist weight loss, are being misused in elite sport. The objective of this study was to investigate sports medicine physicians' perceptions of GLP-1 drug use in sport. METHODS: Following an observational cross-sectional approach, 114 sports medicine physicians completed a survey addressing experiences and perceptions of GLP-1 use in competitive sport. Participants had worked in sports medicine for 16.6 years on average, 63% were male, and 38 countries and 93 sports were represented. Survey data were analysed using descriptive statistics. RESULTS: Twelve percent of physicians were aware of athletes who had used GLP-1 drugs without medical need. Physicians most frequently reported that athletes would consider using GLP-1 drugs to meet weight limits and assist weight loss after injury and would be deterred by a lack of energy to train from a reduced appetite. On average, physicians were moderately concerned about the non-prescription use of GLP-1 drugs in sport from a performance enhancement perspective and from an athlete health and welfare perspective. Forty-four percent of participants believed GLP-1 drugs should be prohibited, although 38% reported being unsure. For those supporting prohibition, harm to an athlete's health was the main concern. CONCLUSIONS: Currently, without evidence on the effects of GLP-1 drugs on athletes' health and performance, a proportionate response for sport is education first, structured therapeutic-use pathways, enhanced monitoring, and accelerated sport-specific research including longer-term clinical follow-up of side effects. The approach protects health and fairness, while creating the evidence base needed to judge whether prohibition is justified.