Rapid uptake of GLP-1 receptor agonists in patients with inflammatory bowel disease: a 14-month repeated cross-sectional survey

Objective Obesity is associated with poor outcomes in inflammatory bowel disease (IBD). We sought to define current obesity management, assess patient interest in weight-loss interventions and quantify changes in glucagon-like peptide-1 receptor agonist (GLP-1 RA) use and prescribing pathways. Methods We conducted two digital surveys of patients with IBD at a large National Health Service (NHS) Trust and one of IBD clinicians nationally. Surveys were distributed via the Electronic Patient Record (EPR) at baseline (December 2024) and follow-up (January 2026). Results In the most recent patient survey, we found that 31.1% (318/1022) of survey respondents living with IBD were obese. Over 14 months, median (IQR) body mass index (BMI) in the cohort rose from 25.7 (IQR 22.8–30.0) to 26.7 (IQR 23.8–31.1) kg/m² (p=6.4×10 −5 ) and self-reported GLP-1 RA use increased fivefold, from 1.6% (18/1093) to 8.2% (86/1054) (p=4.3×10 −12 ). Most patients obtained GLP-1 RAs through online pharmacies, with the primary indication being weight loss in 93.9% (108/115 (95% CIs 88.0% to 97.1%)) patients. GLP-1 RA use was formally recorded in 33.0% (38/115 (95% 25.1 to 42.1)) patients’ EPR. Female sex was independently associated with GLP-1 RA use (OR 1.79, 95% CI 1.12 to 2.94). While 94.1% of clinicians (n=52) believe GLP-1 RAs are safe, 82.7% identified a lack of efficacy data in the IBD population as a major knowledge gap. Interest in clinical trials of GLP-1 RAs as an adjunct to IBD therapy was high among both clinicians (90.4%) and eligible patients (73.9%). Conclusion People living with IBD and obesity want access to weight-loss interventions. There is a rapid, largely hidden surge in direct-to-consumer GLP-1 RA use among patients with IBD. Integrated pathways and prospective trials are urgently needed to monitor safety and evaluate the impact of pharmacological weight loss on IBD disease activity.