Impact of Fasting on Physical Activity Motivation and Weight Reduction in Patients Administered Glucagon-Like Peptide-1 Agonists: A Qualitative Study

Abdullah Almaqhawi,1 Razan Anwar Alabdulqader,2 Nurah Abdullatef Alkhteeb,2 Fai Ibrahim Alomair,2 Sarra Riyadh Alhassan,2 Jawad S Alnajjar2 1Department of Family and Community Medicine, College of Medicine, King Faisal University, Al Hofuf, Saudi Arabia; 2College of Medicine, King Faisal University, Al Hofuf, Saudi ArabiaCorrespondence: Abdullah Almaqhawi, Department of Family Medicine and Community, College of Medicine, King Faisal University, P.O. Box No. 400, Al-Ahsa, 31982, Saudi Arabia, Email [email protected]: This study aims to investigate the possible impacts of fasting on physical activity and weight loss in adult users of glucagon-like peptide-1 (GLP-1) agonists, specifically semaglutide and tirzepatide, using qualitative methods to gain in-depth insights into participants’ experiences and perceptions.Patients and Methods: A qualitative study was conducted at the Polyclinic at King Faisal University, Al-Ahsa, Saudi Arabia, during and after Ramadan in 2024, along with the completion of International Physical Activity Questionnaires (IPAQs). The semi-structured interviews and the IPAQ were used to assess physical activity levels. A thematic narrative and framework analysis were used to analyze the data, and a descriptive analysis was performed on the IPAQ data. All participants provided their informed consent, and ethical approval was acquired. A total of 14 interviews were conducted. Five refined themes and 3 sub-themes were identified. The findings were presented in accordance with the COREQ (consolidated criteria for reporting qualitative research) guidelines.Results: Ten participants, aged 18– 59, were included in the study. Half used semaglutide, four used tirzepatide, and one used both, primarily for blood glucose regulation and weight reduction. The average body mass index (BMI) decreased from 35.246 to 34.155. However, a paired t-test showed this change was not statistically significant, suggesting that Ramadan fasting did not significantly impact BMI in participants.Conclusion: The research indicated that the combination of GLP-1 agonists and physical activity influenced weight loss during fasting in Ramadan among the participants. These findings suggest that combining these medications with increased physical activity and fasting can effectively reduce BMI and improve overall health outcomes for individuals managing weight and chronic diseases over an extended duration.Keywords: physical activity, glucagon-like peptide-1 agonists, semaglutide, tirzepatide, weight loss, Ramadan, qualitative study, thematic analysis