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Jump to Key Points A new scientific statement from the Endocrine Society aims to summarize current knowledge about obesity, while also emphasizing unanswered questions and research opportunities.
The document, "Obesity Science, Research Gaps, and Opportunities in the New Era of Obesity Medicines: An Endocrine Society Scientific Statement", was published online September 9, 2026 in Endocrine Reviews. It was timed along with the launch of the society's new initiative, called the Center on Obesity.
The new statement covers these main six areas in detail:
- The pathophysiology of obesity with a focus on body fat regulation/defended fat mass
- The heterogeneity of obesity with a focus on treatment response
- Redefining treatment targets beyond percent total body weight loss
- The physiology of phases of treatment response to pharmacotherapy
- Health outcomes with pharmacotherapy
- Safety of pharmacotherapy
"We've never had the opportunity to treat obesity like we've had in the last five years with these new medicines… This document outlines the science of what we know, what do we not know, and what we should prioritize to answer now that we have these powerful tools. The answers, in many cases, have immediate clinical relevance," document lead author Daniel J. Drucker, MD, Lunenfeld-Tanenbaum Research Institute, University of Toronto, Canada, told Medscape Medical News.
- Endocrine Society statement reviews obesity science + research gaps in GLP-1 era.
- Emphasizes defended fat mass, obesity heterogeneity, and variable treatment response.
- Calls for targets beyond % total body weight loss alone.
- Priorities: time course of medication response, health outcomes, long-term safety.
- Concerns include muscle, bone effects; pregnancy timing; dose adjustment; monitoring.
It's intentionally not meant to be proscriptive, he noted. "It's basically raising the key issues and questions that are important and need to be answered, while providing a background state of knowledge to say what is the science that we currently understand surrounding these issues, what are the strengths and limitations, and what studies do we need to do to put us all on a better footing to move the field forward."
During an Endocrine Society briefing, Drucker also listed the following research priorities from the statement:
- How the body responds to obesity medications over time
- Health outcomes with obesity medications
- Long-term safety of new obesity medications, including GLP-1s
"I think it's very helpful to have a document like this to remind us where we've come from, where we need to go, and how should we move forward as a community to answer these questions and improve health outcomes in this very important area," he said during the briefing.
"Companion Piece" to Clinical Guidance
Asked to comment on the statement, Obesity Society spokesperson Melissa Shoemaker, MD, of the University of Texas Southwestern Medical Center, Dallas, told Medscape that she sees it as "a companion piece to existing clinical guidance."
In particular, Shoemaker said she appreciated the sections on the limitations of BMI and percent weight loss as the sole measures of obesity and treatment success, the need to determine the optimal rate of weight loss, the importance of ongoing patient monitoring, and optimal dose adjustment.
And, she said that the discussions on treatment risks and benefits, such as potential effects on muscle and bone and treatment prior to pregnancy, are valuable because "there are individual scenarios that we encounter and are still operating on a trial and error basis. The article provides the scientific framework for understanding why we do what we do, identifies where our current approaches may fall short and lays out many of the questions the field still needs to answer. For clinicians engaged in obesity care, much of it will resonate with what we are already seeing and asking in clinic."
Also asked to comment, Juliana S. Simonetti, MD, co-director of the weight management program at the University of Utah, Salt Lake City, said "it's a great paper for learning the science behind the physiology and what we know so far."
However, Simonetti, a co-author of the American Association of Clinical Endocrinologists' obesity guidelines, added she would have liked to see more specific mention of racial and ethnic differences in obesity. "Adiposity within different populations varies a lot. Much lower amounts of fat tissue can lead to much higher rates of obesity-related medical complications."
Center on Obesity: Promoting Obesity Advances
Speaking during the briefing, Amy E. Rothberg, MD, clinical professor of internal medicine and director of the weight management clinic at the University of Michigan, Ann Arbor, said that the society's new Center on Obesity "seeks to accelerate scientific understanding of obesity and, of course, advance its treatment. We're harnessing our members' expertise in the hormonal causes of obesity and its treatment, and together we can improve the landscape for one in eight people worldwide living with obesity."
The Center features programs and resources for members, curates the latest articles on obesity from the Endocrine Society's journals — including the new statement — and provides information on upcoming meetings, events, and educational and advocacy opportunities to increase research and access to care, said Rothberg, who chaired the society's Obesity Task Force that developed the Center.
"We're also updating our clinical practice guideline on obesity medications to help clinicians navigate this rapidly evolving landscape. We expect to publish the new guideline in January 2027," she concluded.
Drucker has served as a speaker within the past 12 months for Novo Nordisk, and Eli Lilly and as a consultant to Alnylam, Amgen, AstraZeneca, Crinetics, Eli Lilly, General Medicines, Kallyope, Merck, Pfizer, Protagonist Therapeutics, Roche, and Sanofi. He holds nonexercised options in Kallyope. GLP-2 is the subject of a patent license agreement between Takeda and the University of Toronto, Toronto General Hospital, and himself. Rothberg reports grant funding from Abbott, Fractyl, and Boehringer Ingelheim, consulting fees from Boehringer Ingelheim, honoraria from CME Outfitters, expert testimony payment from DLA Piper, and leadership as well as travel and meeting support from the Endocrine Society and the American Board of Obesity Medicine Board of Directors. Simonetti has consulted for Rhythm Pharmaceuticals and Eli Lilly. Shoemaker has no relevant disclosures.
Miriam E. Tucker is a freelance journalist based in the Washington DC area. She is a regular contributor to Medscape, with other work appearing in the Washington Post, NPR's Shots blog, and Diatribe. She is on X (formerly Twitter) @MiriamETucker and BlueSky @miriametucker.bsky.social
