As of 2025, the obesity treatment landscape continues to evolve. Injectable GLP-1 receptor agonists have set new clinical benchmarks, achieving 15–20% average weight reduction and improving cardiometabolic outcomes in adults with obesity. Yet real-world use often lags, hampered by injection hesitancy, supply constraints, and insurance variability.

Emerging research suggests the next frontier may lie with oral GLP-1–based therapies. In phase 3 studies, these agents have delivered weight reductions of 14–15%, closely mirroring injectables. Meanwhile, early-phase data on dual and triple agonists targeting GLP-1, glucagon, and amylin pathways show promising results, with up to 24% reductions reported in select populations. Gastrointestinal effects remain the most common treatment-related events and are typically mild and transient.

As these therapies near clinical integration, clinicians must consider how oral options will complement current care models—aligning with behavioral interventions, supporting adherence, and broadening access. Framing obesity as a chronic, manageable disease remains key, with new therapies positioned as tools for long-term metabolic health.

Pharmacologic therapy—oral or injectable—should enhance, not replace, nutritional, behavioral, and physical activity strategies. As HCPs, your role is pivotal in ensuring optimal treatment pairing and fostering durable outcomes.

Which of your patients might be best suited for oral anti-obesity therapy once available? What strategies have been most effective in supporting adherence and tracking response over time?

Obesity is increasingly recognized not merely as a lifestyle issue, but as a chronic, relapsing disease requiring sustained clinical management. Despite rising prevalence and cardiometabolic risks, pharmacologic treatment remains underutilized. While lifestyle interventions are foundational, maintaining weight loss over time through lifestyle changes alone is often challenging. High-intensity behavioral interventions may yield 5–8% total body weight loss, but this often plateaus or regresses by 12 months.

US clinical guidelines recommend anti-obesity medications when BMI is ≥30 kg/m², or ≥27 kg/m² with comorbidities. However, fewer than 2% of eligible patients receive prescriptions. Barriers such as stigma, limited access to specialists, and coverage restrictions may contribute to low treatment rates. GLP-1 receptor agonists, among newer therapies, address the biological drivers of obesity and have demonstrated significant weight loss (>10–20%) and cardiovascular risk reduction in clinical trials.

With an expanding range of therapeutic options, the focus is shifting to identifying the right patients and aligning treatment with their individual clinical needs and goals. Long-term success often depends not just on initiating therapy, but on sustaining it over time.

What clinical factors guide your decision to initiate pharmacologic therapy for obesity, and how do you approach patient selection, support long-term adherence, and identify those most likely to achieve sustained outcomes?