Abstract
BACKGROUND: Over the past decades, the global prevalence of obesity has tripled, with the Kingdom of Saudi Arabia experiencing a notably higher rate of increase. While lifestyle modifications remain the first line of treatment, pharmacological interventions are often employed when dietary and exercise interventions prove insufficient. However, safety concerns, misuse, and limited knowledge about weight management medications (WMMs) pose serious challenges. OBJECTIVES: The objectives of this study were to determine the level of knowledge and examine attitudes towards WMMs among the general population, and to explore the factors associated with these knowledge levels and attitude patterns. METHODS: A cross-sectional study was conducted among adults from the general population in Saudi Arabia from January 2023 to May 2023. Participants completed a validated, self-administered electronic questionnaire in Arabic language. The questionnaire captured sociodemographic, lifestyle and health data, knowledge about WMMs, and attitudes toward them. The outcome measures included knowledge and attitudes scores. Factors associated with knowledge and attitudes were analyzed using chi-square tests. Statistical significance was determined at a p-value of <0.05. RESULTS: Around 716 respondents were included in the final analysis. Most of the participants acknowledged diet 565 (78.9%) and exercise 621 (86.7%) as effective strategies to lose weight. Only 222 (31.0%) participants recognized pharmaceutical medications as a weight management strategy. Knowledge about specific weight loss medications varied, with the highest recognition for semaglutide (Ozempic®, Novo Nordisk, Bagsværd, Denmark) 236 (33.0%) and liraglutide (Saxenda®, Novo Nordisk, Bagsværd, Denmark) 228 (31.8%), while the other WMMs were not commonly known between participants. Regarding attitudes, the majority disagreed with statements that WMMs are more effective than diet/exercise 413 (57.7%), are safe 405 (56.6%), and are more convenient to use 408 (57.0%). Notably, about three-quarters [534 (74.6%)] of participants agreed that these medications require specialist's counseling. No correlation was observed between knowledge score and attitude score (Pearson's correlation coefficient r=0.03; p=0.330). Respondents' knowledge about WMMs was significantly influenced by age, monthly income, educational level, psychiatric history, and previous use of WMMs (p<0.05). Adequate knowledge was more prevalent among participants aged 26-35, earning more than 20K SAR monthly, postgraduates, those with a psychiatric history, and past users of WMMs. Attitudes toward WMMs, however, showed no significant association with sociodemographic or health-related factors (p>0.05). However, prior use of WMMs significantly correlated with attitudes (p=0.007), with past users demonstrating more favorable attitudes. CONCLUSION: This study reveals a limited knowledge and cautious attitude regarding WMMs in the Saudi population, despite the high prevalence of obesity. With prior use of WMMs correlating with better knowledge and more favorable attitudes, these findings emphasize the need for targeted interventions to enhance public awareness and safe usage of these medications.