A new survey has exposed significant gaps in American understanding of GLP-1 medications, the popular class of drugs transforming weight loss and diabetes treatment. Nearly six in ten respondents could not explain how the drugs work, while many reported turning to risky alternatives due to high costs.

GLP-1s and their medical uses

GLP-1 receptor agonists, commonly known as GLP-1s, mimic a natural gut hormone that regulates blood sugar and appetite. They stimulate insulin release after meals, suppress glucagon, and slow digestion to promote fullness. Clinical trials show average weight loss of 12% for semaglutide and 18% for tirzepatide after one year.

The US Food and Drug Administration approved semaglutide for diabetes in 2017 under the brand Ozempic and for weight management as Wegovy in 2021. Tirzepatide followed in 2022 as Mounjaro for diabetes and Zepbound for obesity. Recent approvals include semaglutide for kidney disease and metabolic dysfunction-associated steatohepatitis in 2025, and tirzepatide for moderate-to-severe obstructive sleep apnoea in late 2024. A generic liraglutide was also approved in August 2025, priced about 30% lower than branded Saxenda.

Gaps in knowledge and safety concerns

Levity’s latest survey found that 58% of Americans could not confidently explain how GLP-1s work. About 15% had received incorrect or misleading information from a healthcare provider, pharmacist, or online source, and 26% had encountered unsafe GLP-1 advice on TikTok.

A total of 22% admitted using a weight loss product not prescribed by a medical professional. The survey also revealed that 13% of respondents had used GLP-1s, while 37% knew someone who had. Broader national surveys show usage rates at around 11.8%, with the highest among women aged 50–64 and 17% of Gen Z users influenced by social media.

Social platforms continue to fuel misinformation. “Reliable sources like FDA.gov or consultations ensure safe use,” says a 2025 American Pharmacists Association review, warning against TikTok’s echo chambers. Levity adds that “personalised plans and professional guidance are essential to manage costs and side effects safely.”

Costs continue to drive unsafe decisions

Access remains a challenge. FDA-approved versions of semaglutide and tirzepatide cost more than $1,000 per month without insurance. Although shortages were resolved by May 2025, compounded versions that once offered cheaper alternatives have been discontinued due to safety risks.

Levity’s data show that affordability pressures lead many to compromise on safety:

• 26% would seek alternatives outside a doctor’s office if insurance did not cover GLP-1s.
• 31% would switch insurance providers to gain access.
• 21% of current users have skipped doses, delayed refills, or stopped treatment due to cost.

Insurance coverage remains inconsistent. Only 52% of employers cover GLP-1s for obesity, according to WTW’s 2025 report, with average costs rising from $4 per member monthly in 2022 to $27 in 2025. Among Levity’s respondents, 88% have health insurance, but coverage varies: 7% fully covered, 15% partially, 27% not covered, and 51% uncertain. Nine states include coverage through Medicaid, 11 through employee plans, and 83% of commercial policies still require prior authorisation.

President Trump’s April 2025 rejection of Medicare obesity coverage expansion has further deepened the gap. Experts continue to call for value-based pricing models, such as Eli Lilly’s $399 self-pay vials for Zepbound, to make treatment safer and more accessible.

Health implications and public awareness

GLP-1s offer benefits beyond weight loss, including reduced cardiovascular risk and improved blood pressure and lipid levels. Semaglutide has been shown to lower major cardiac events by up to 20% in high-risk patients. Common side effects include nausea, vomiting, diarrhoea, and constipation, affecting up to half of new users but often easing over time. Rare complications include pancreatitis and gallbladder issues.

Despite these advantages, widespread confusion threatens safe use. Levity’s findings highlight the need for accurate education as GLP-1s reshape obesity care across the US.