GLP-1 receptor agonists have transformed the treatment landscape for obesity and diabetes, and for good reason. Clinical trials have consistently shown meaningful improvements in body weight, glycemic control, cardiovascular risk factors, and, among people living with diabetes, medication and insulin needs. Many modern trials also include patient-reported outcome measures, reflecting a growing recognition that treatment success extends beyond traditional clinical endpoints. Still, the broader conversation around GLP-1s often centers on the most visible metrics: pounds lost, A1C lowered, and cardiometabolic risk reduced. Those measures are essential, but they may not fully capture what makes therapy feel successful to the people taking it. (Springer)

Clinical Success and Patient Success

At Thrivable, this question came into sharper focus during our recent Thrivable 365 research, where we analyzed more than 3,500 audio-recorded responses from 591 people living with diabetes who were using GLP-1 therapies. Participants certainly discussed weight loss, improved glucose control, and insulin reduction, but many also described benefits that are harder to quantify: less anxiety, greater confidence, reduced “food noise,” and a sense that diabetes occupied less mental space in their daily lives. One participant described feeling “way more in control, and mentally healthier,” while another said their blood sugar felt more stable and they worried less about sudden highs and lows.

The most thought-provoking finding was that improvements in mental health—not weight loss or insulin reduction—were the strongest predictor of a participant’s intention to remain on therapy long term. That does not diminish the importance of traditional clinical outcomes. Rather, it suggests that people may evaluate treatment success using a broader set of criteria than the ones most often emphasized in clinical and commercial conversations.

Despite the widespread popularity of GLP-1 medications in the U.S., nearly three in four diabetes patients stop treatment within a year. To better understand this, Thrivable collected 3,500 open-ended audio responses from 591 people with type 1 and type 2 diabetes using GLP-1s. DOWNLOAD WHITE PAPER >>

The Science Is Beginning to Catch Up

This observation is increasingly consistent with the published literature. Analyses from obesity trials have shown that GLP-1 and dual incretin therapies can improve health-related quality of life, physical functioning, and psychosocial well-being, in addition to producing weight loss and metabolic benefits. (PubMed)

Researchers are also beginning to study concepts that patients have been describing for years, including changes in appetite-related thoughts, eating behavior, psychological hunger, and “food noise.” A recent qualitative study of GLP-1 users across health contexts found that patients often described reduced food noise, greater perceived control, and changes in their relationship with eating—experiences that mirror many of the themes we heard in our own research. (JAMA Network)

Importantly, this is not an argument that clinical trials ignore patient experience. The FDA’s Patient-Focused Drug Development guidance explicitly encourages the use of fit-for-purpose clinical outcome assessments that capture outcomes meaningful to patients. The challenge is less about whether patient experience matters in theory, and more about whether the broader GLP-1 conversation has fully caught up to what patients are telling us. (U.S. Food and Drug Administration)

Expanding How We Define Success

Weight loss, A1C, cardiovascular outcomes, safety, and tolerability will always remain central to evaluating GLP-1 therapies. They are clinically meaningful, measurable, and necessary for regulatory and clinical decision-making. But as these therapies become more widely used across obesity and diabetes care, we may need a more complete definition of success—one that includes how therapy changes daily life.

If two people achieve similar weight loss or glycemic improvement, but one still feels consumed by food decisions while the other feels less anxious, more confident, and more able to manage daily routines, those are meaningfully different treatment experiences. Traditional endpoints may show that the therapy worked in both cases, but patient experience helps explain what that success actually meant.

At Thrivable, we believe the strongest healthcare insights come from integrating clinical evidence with patient voice. Clinical outcomes help us understand whether a therapy improves health. Listening to patients helps us understand how those improvements translate into lived experience. As GLP-1 therapies continue to reshape diabetes and obesity care, the opportunity is not to replace traditional endpoints, but to ensure we are measuring all of the outcomes that matter.