Changes in Eating Behavior and Food Preferences After Semaglutide or Tirzepatide Initiation: A Prospective Observational Pilot Study

Background: This pilot study evaluated changes in eating behavior, appetite, and dietary habits during semaglutide or tirzepatide treatment in adults with obesity. Methods: In this prospective observational study, 38 non-diabetic adults with obesity (mean age 56.1 ± 11.3 years; 73.7% female; BMI 32.7 ± 4.5 kg/m2) initiating semaglutide (n = 21) or tirzepatide (n = 17) were assessed at baseline and after 3 months. Clinical parameters and self-reported eating behaviors were evaluated using standardized measurements and a study-specific questionnaire. Results: Mean body weight decreased by 7.2 ± 4.9 kg (p < 0.001), and systolic blood pressure decreased by 6.1 ± 6.3 mm Hg (p < 0.001). Cravings for sweet and savory foods, difficulty resisting hunger between meals, and daily meal frequency decreased, whereas perceived meal-induced satiety increased (all p ≤ 0.005). A substantial reduction in meal portion size was reported by 84.2% of participants. Reported food-group consumption changed, but improved overall dietary quality was not established. Conclusions: Over 3 months, incretin-based treatment was accompanied by weight loss and changes in self-reported eating behavior. The observational design, absence of a control group, and unvalidated questionnaire limit interpretation. Larger controlled studies using validated measures are warranted.