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Can new obesity therapies reshape long-term adherence and care models?

Obesity treatment is shifting toward long-term disease management—where the goal is not only to reduce weight but also to maintain it safely and sustainably. New agents targeting gut–brain and metabolic pathways have expanded available treatment options, while also underscoring the need to address long-term engagement.

Adherence remains a key challenge. Real-world evidence shows that many patients discontinue therapy within the first year, often due to side effects, administration burden, or mismatched expectations. As new formats emerge—including oral formulations—treatment strategies are evolving to better align with patient preferences and routines.

Studies suggest that mode and frequency of administration can influence persistence. Some patients prefer the simplicity of once-weekly injections; others find daily oral dosing easier to incorporate. These differences highlight the need for early, personalized conversations about lifestyle fit, tolerability, and long-term commitment.

Pharmacotherapy is just one pillar of sustainable obesity care. Lasting outcomes still rely on nutrition, behavioral support, and structured follow-up. The opportunity now lies in integrating these therapies into adaptable models that reinforce patient engagement well beyond the initial response.

How do you navigate adherence challenges when patients transition between therapy formats? What potential do emerging oral options hold for improving persistence in long-term obesity care?

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  • 6d
    I feel some patients will be better suited for the oral therapies, as many of these patients already take daily medications. Some patients struggle with remembering to take medication weekly. Therefore, for some patients, a daily oral medication may work better for them in regard to adherence than for others. I think the biggest challenge for switching from one therapy to another is going to potentially be cost since we do not know how much the oral formulations will cost. Also, side effects may be slightly different switching from one formulation to another. Oral medications, like injectables, can be continued as maintenance medications for long-term obesity care. Once goals are reached, patients can be kept on maintenance therapy.
  • 1w
    Patients needs to do
    Lifetime changes to keep weight loss and making the best food choices with assistance of nutritionist and AI
  • 1w
    Main issue remains cost. Until drugs are affordable, effective and sustainable options are a challenge
  • 1w
    Most prefer weekly doses and that mitigates some compliance issues. Need to educate on controlling side effects and set reasonable goals of treatment.
  • 1w
    Educating patients as to what to expect and how to mitigate side effects will change adherence.
  • 1mo
    Oral options provide another avenue for patients that desire weight loss. Many times getting an understanding as to the reasoning behind desire to change therapy format or discontinue and to dispel any myths
  • 1mo
    One of the biggest hurdles in treatment of obesity with inject-able medications is the cost of care and insurance patients may prefer daily oral treatment while others may find once weekly dosage more convenient. Some expect the med to be more effective than what they experience and adequate education and goal setting with patients is imperative.
  • 1mo
    Yes, obesity medications motivate patients to change their lifestyles in a positive way. Will have lasting results for many.
  • 1mo
    They could and should. Obesity was defined as a disease by the AMA in 2006. Very few insurances cover them even though numerous studies show cost savings longer term with a thinner population. If they were affordable, more patients would be able to lose weight and sustain the weight loss with continued treatment.
  • 1mo
    I for one think that when more oral formulations will become available , the preferences on insurance tiers will shift depending also on consumer demand ( oral vs injectable preference and tolerability) ; what is promising is that with oral therapy efficacy is improving and can become the norm for maintenance therapy for chronic obesity treatment. Improvement in nutrition adherence with AI help( having a personal AI companion that can guide you through making best nutrition choices and connected with grocery stores in the area for prices will be the future as I see it. This will increase adherence to continuous treatment.

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