Today, I review, link to, and excerpt from the Obesity Association‘s “Pharmacologic Treatment of Obesity in Adults: Standards of Care in Overweight and Obesity”. [PubMed Abstract] [Full-Text HTML] [Full-Text PDF]. BMJ Open Diabetes Res Care. 2026 Jan 13;13(Suppl 1):e005729. doi: 10.1136/bmjdrc-2025-005729.
All that follows is from the above resource
Abstract
Obesity medications may be part of a comprehensive care plan for adults with obesity. The Obesity Association, a division of the American Diabetes Association (ADA), developed comprehensive, evidence-based guidelines on the pharmacologic treatment of obesity in adults. When used in conjunction with lifestyle modifications, obesity medications have demonstrated efficacy in inducing and sustaining weight reduction while concurrently improving clinical outcomes of obesity and obesity-related diseases and complications. Healthcare professionals should engage people with obesity in a person-centered, shared decision-making approach when selecting an obesity medication to optimize health outcomes while emphasizing individual needs and preferences. The ADA’s Obesity Association encourages healthcare professionals to adopt these guidelines for treatment of obesity in adults.
Keywords: Drug Therapy; Obesity; Pharmacology; Practice Guideline.
© 2026, American Diabetes Association, Inc., and BMJ Publishing Group Limited.
Obesity medications are an essential component of a
comprehensive approach to obesity management, offering significant benefits beyond lifestyle interventions
alone for many people. Research indicates that pharmacotherapy can lead to greater weight reduction and improved weight maintenance than placebo in adults with
obesity (1). Of note, randomized controlled trials (RCTs)
of obesity medications include lifestyle intervention in
both placebo and study drug arms, which most typically comprises a 500-calorie deficit meal plan and behavioral intervention that usually produces 2.6% weight
reduction in the placebo group (2), and the placebo
group receives a placebo pill or injection, as appropriate. In meta-analyses of RCTs, people treated with obesity medications experienced substantial weight
reduction compared with placebo (2,3). Participants
treated with obesity medications also had improvements
in cardiometabolic markers, such as glycemia and lipid profiles (2,3), and some obesity medications demonstrated
improvements in cardiovascular outcomes and other obesity-related diseases (4–7). When used appropriately, obesity medications offer a favorable risk-benefit profile in
many cases, making them a viable option for many people
with obesity.As obesity medications induce clinically meaningful
weight reduction relative to placebo (2,18), the choice of
therapy should prioritize medications most likely to improve obesity-related diseases and complications and to
achieve and maintain weight reduction goals. Therefore,
this section outlines an approach focused on reducing
risk of and burden from obesity-related diseases rather
than solely focusing on weight reduction goals. Table 2.1
contains a summary of treatment and weight-reduction
outcomes as well as adverse effects reported in RCTs of
obesity medications. The risk of medication-related adverse effects should be evaluated for each individual, as
this risk may vary depending on their medical history and
concomitant medications. In a network meta-analysis
(132 RCTs), adverse events leading to drug discontinuation were significantly higher for all obesity medications
compared with placebo (2). Health care professionals
should present the potential benefits, risks, and expected
outcomes of obesity medications. Medication selection
should be guided by person-centered factors, including evidence, treatment burden, costs, and individuals’ therapeutic
goals and preferences.Behavioral Lifestyle Therapy With Obesity
MedicationsNutrition, physical activity, and behavioral therapy must be
components of all comprehensive obesity treatment plans,
including those with obesity medications. The efficacy of
obesity treatment interventions that include nutrition and
physical activity have been documented in meta-analyses
(1,19,20), and the addition of obesity medications to lifestyle
interventions improves weight reduction and weight loss
maintenance (1,19,21).
Greater weight reduction may be achieved when a lifestyle
behavioral modification program is administered with an
obesity medication among individuals with obesity (22–25).
For example, in a 1-year RCT, participants in a naltrexonebupropion plus intensive behavioral program group lost
9.3% of baseline weight compared with 5.1% in the placebo
plus intensive behavioral program group (22). The degree of
weight reduction achieved is related to program intensity
(20), and engagement in behavioral components is also associated with greater weight reduction (26). Some obesity
medications are associated with increased fullness as well
as decreased hunger, food preoccupation, dietary disinhibition, and binge eating compared with placebo (27,28),
which may aid individuals in achieving and sustaining the
lifestyle treatment plan.
Weight-Promoting Medications
