biggest challenge is coverage. Success with weight loss makes adherence much easier.

Having more oral agents with novel mechanisms of actions is a happy thought, but the cost of these dual and triple agents is going to be a major factor. If you cannot afford the medication, you cannot adhere to the medication. Compliance is already challenge even when a medication is close to zero cost out of pocket. New and shiny toys are going to remain on underutilized if physicians do not understand the benefits of the newer agents.

The three main barriers to adherence for these medication's include affordability, weight loss outcome and side effects. Transitioning between products whether oral or injectables is not critical, just as long as the three barriers need to be addressed. It's a matter of finding the balance between these three barriers that keeps patients engaged.

Obesity is the most complex of the chronic disease to manage on long term basis as compared to Diabetes , HTN and Hyperlipidemia as in obesity management it involves the most fundamental antagnoist and that is food intake which is needed to satiate the hunger for survival on every day basis and some where in its pursuit it blends in to appetite which is a rathter psychological phenomenon and the pleaure seeking forces take over and that is where we battle it with one medicine or the other ! So to have an ultra long acting agent or a preferred oral agent to modulate this basic human fucntion is challenging every day and the impulse and desire to eat can override any sophisticated molecule or surgical intervention for anatomical restructuring ! Optimal management of obesity involves continued counselling and follow up on diet and exercise regimen and to inculcate cognizance of the morbidity assocaited with obesity . An insight and knowledge of different agents avialable and the one in pipe lines helps in using them at one time or the other ! An ultra long acting agent has the potential of side effects which will persist for some time and will be best suited for pts who have tolerated the shorter acting version . An oral agent may not be as promising and well received with the exception of needle phobic pt as majority are used the weekly injection and with the expectant price reduction in near future will be most sought after ones

Yes—new obesity therapies can meaningfully reshape long-term adherence and care models, but only if they’re deployed within a chronic-disease framework that anticipates transitions, normalizes persistence challenges, and keeps patients engaged beyond the first response. What’s changing isn’t just what we prescribe, but how we manage obesity over time.

So the first part navigate is to find out what the compliance issue is. If it’s ease if it’s cost if it’s some other social barrier. Then focus on overcoming that barrier. As far as transitioning between therapies, that’s usually in my mind the purview of the patient. If they prefer once weekly injection, that’s fine if they prefer once daily pill that’s fine to me it’s six of 1/2 dozen of the other as far as potential for the emerging therapies obviously, having an oral version gives you the ability to move back-and-forth also potentially if the cost improves by having other options available that expands the reach and helps to eliminate the cost barrier

There's a huge emergence in anti obesity medications rather it's injectable or oral medications. That is a part of weight loss but shouldn't be regarded as the only intervention for weight loss as this will not work in the long run. I still do monthly checks on the patient, as well as health coach sessions and behavioral health if needed. Oral therapy is helpful as a alternative but not a huge factor since injectables has become widely available and I found oral therapy to have more nausea/vomiting intolerance to it as well.

For all oral medications for different diseases, adherence is a dismal 35 percent. I expect similar challenges with oral AOM probably to a lesser extent. I think once a week or better yet, once a month injection ( MARITIDE, currently in development ) would prove to have better adherence rates. Life style and behavior modifications are crucial part of a patient's weight loss journey and should always be part of the game plan

Emerging oral obesity medications offer substantial potential for improving long-term persistence. By eliminating injection-related barriers, oral formulations may enhance patient access, adherence, and satisfaction, particularly for individuals who prefer oral administration or experience injection-site reactions

Injection adherence is not the issue, it is potential GI side effect costs. Oral options may be less expensive. Most patients do great with injections, but oral will fit in good for others. Injections appear to be more effective at this minute if dose is escalated.

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.

Patients needs to do
Lifetime changes to keep weight loss and making the best food choices with assistance of nutritionist and AI

Main issue remains cost. Until drugs are affordable, effective and sustainable options are a challenge

Most prefer weekly doses and that mitigates some compliance issues. Need to educate on controlling side effects and set reasonable goals of treatment.

Educating patients as to what to expect and how to mitigate side effects will change adherence.

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

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.

Yes, obesity medications motivate patients to change their lifestyles in a positive way. Will have lasting results for many.

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.

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.