Associations of taste intensity changes with appetite during incretin-based therapy in obesity

Abstract Background GLP-1 receptor agonists (GLP-1 RAs) and dual GIP/GLP-1 RAs induce weight loss and reduce appetite. However, their effects on taste perception remain unclear. While some studies reported increased taste sensitivity and neural activation in response to sweet stimuli, others found reduced taste function. This study examined associations between self-reported taste perception changes and appetite-related outcomes in individuals with overweight or obesity receiving incretin-based therapies. Methods A cross-sectional survey was conducted among 411 adults with overweight/obesity, 35% with type 2 diabetes. Participants were grouped by treatment: semaglutide (Wegovy, n = 217), semaglutide (Ozempic, n = 148), tirzepatide (Mounjaro, n = 46). Data on sociodemographics, anthropometrics, appetite, and sensory changes were collected online. Weight loss was compared using Kruskal-Wallis tests. Multivariable logistic regression models assessed associations between changes in sweet and salty taste perception and appetite-related outcomes (satiety, appetite, cravings). Results Median weight loss after ≤6 months: Wegovy 8.25 kg, Ozempic 7.8 kg, Mounjaro 10.25 kg (p = 0.039); after ≥12 months: Wegovy 20.15 kg, Ozempic 21.3 kg, Mounjaro 24.15 kg (p = 0.006). Reduced appetite was reported by 58.4%, increased satiety by 63.5%. Sweet taste perception increased in 20.4%, salty taste in 21.7% (no significant group differences). Increased sweet taste perception was significantly associated with increased satiety (AOR=2.04), reduced appetite (AOR=1.67), and reduced craving (AOR=1.87). Increased salty taste perception was associated with higher satiety (AOR=2.16; all p < 0.05). Conclusions Despite differences in weight loss, self-reported taste perception changes were similar across treatments. These sensory changes were significantly associated with favourable appetite-related outcomes, suggesting a possible behavioural mechanism supporting the therapeutic effects of incretin-based therapies. Key messages • Changes in taste perception may contribute to appetite suppression and craving reduction under GLP-1-based treatment. • Self-reported sensory changes could serve as patient-relevant indicators of treatment response beyond weight loss.