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Survey on Audiological Side Effects of Weight Loss Injections

This survey aims to collect anonymous research data on potential hearing-related side effects associated with weight loss injections. All responses will only be used for academic research purposes. Please answer all questions based on your actual experience.
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1. Do you consent to have your response data used for this academic research study?
Yes, I consent
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2. Your gender
Male
Female
Non-binary
Prefer not to say
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3. Your age group
18-24

25-39

40-64

65 and over
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4. Your ethnicity
White
Black or African American
Asian

Middle Eastern

Multiple ethnicities
Other
Prefer not to say
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5. Have you ever used or are you currently using weight loss injections?
Yes, I am currently using them
Yes, I have used them in the past
No, I have never used them
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6. What brand of weight loss injection medication have you used?
Wegovy (semaglutide)
Ozempic (semaglutide)
Mounjaro (tirzepatide)
Saxenda (liraglutide)
Other brand
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7. Did you consult a doctor before starting to use weight loss injections?

Yes
No
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8. Were you offered any alternative weight loss methods by your doctor prior to starting the injections?
Yes
No
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9. Were you advised of any potential audiological (hearing-related) side effects prior to starting the medication?
Yes
No
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10. Did you experience any hearing loss before you started using weight loss injections?
Yes
No
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11. Did you suffer from tinnitus (ringing, buzzing or other persistent noise in the ears) before you started using weight loss injections?
Yes
No
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12. Have you suffered from tinnitus during your use of weight loss injections?
Yes
No
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13. Did you notice any new or worsening hearing loss during your use of weight loss injections?
Yes
No
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14. Have either tinnitus or hearing loss symptoms continued after you stopped using the injections?
Yes, both symptoms continued
Yes, only tinnitus continued
Yes, only hearing loss continued

No, neither symptom has continued

Neither symptom has been experienced

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15. If you had known about these potential hearing-related side effects prior to starting the injections, would you still have used them?
Yes
No
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16. How long did you use or have you been using the weight loss injections?
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17. If you had to choose, which would be of higher priority for you?
Hearing health
Weight loss
18. Do you have any additional information, comments, or related experiences you would like to share about this topic?
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