The Obesity Association, a division of the American Diabetes Association (ADA), has issued new standards of care on the pharmacologic treatment of obesity and overweight in adults.

The document, authored by the ADA’s Professional Practice Committee for Obesity, was published on January 13, 2026, in the ADA’s new journal Diabetes, Obesity, and Cardiometabolic Care, which launched in January 2026. It is the third chapter of the Association’s Standards of Obesity Care, following an introduction and first chapter addressing weight stigma and bias, both published in BMJ Open Diabetes Research & Care.

Covered topics in the new chapter include discussing obesity medications and lifestyle therapy with patients using a patient-centered approach, minimizing the use of weight-promoting medications as possible, setting treatment goals, selecting appropriate medications, and dose adjustment.

“Setting treatment goals should be incremental and individualized taking into consideration the severity of obesity and obesity-related diseases and complications, as well as the individual’s needs and preferences…The recommendation to consider a range of treatment goals, rather than one blanket recommendation, allows for individualization of therapy recognizing that obesity is a heterogenous chronic disease with varying impacts on health,” Obesity Association Vice President Samar Hafida, MD, told Medscape Medical News.

Additional separate sections address the use of obesity medications in individuals with concomitant conditions, including prediabetes, type 2 diabetes, hypertension, atherosclerotic cardiovascular disease, heart failure with preserved ejection fraction, metabolic dysfunction-associated steatohepatitis, obstructive sleep apnea, and osteoarthritis.

“The chapter provides detailed guidance on specific medication classes to select, according to their proven health benefit,” noted Hafida, an adult endocrinologist at the Joslin Diabetes Center, Boston.

The document also covers long-term management of obesity medications, inadequate treatment response, and lifestyle intervention with the medications. “Evidence supports the recommendation to continue treatment with medications after attaining treatment goals to avoid weight recurrence and reemergence of cardiometabolic risk factors and obesity-related diseases and complications,” she said.

Final sections address special populations and circumstances, including people of childbearing potential, compounded medications, and clinical practice considerations.

“To make the best use of the document, clinicians should focus on guidance provided to their clinical flow, practice settings, training and skill acquisition in addition to recommendations for selecting which medication to start. Understanding which medications have proven health benefits, how to titrate, and when to refer are strategies available to the clinician in this chapter,” Hafida said.

Another Set of Obesity Medication Guidelines Expected Soon

The ADA Obesity Association document will soon have company. Joint guidelines on US-based pharmacologic management of overweight/obesity and its complications in adults are expected to be released in late January 2026 by The Obesity Society (TOS), the Obesity Medicine Association (OMA), and the advocacy group Obesity Action Coalition (OAC). A preview of that document was presented in November 2025 at the Obesity Week conference.

Asked to comment on the ADA document, TOS President Jonathan Q. Purnell, MD, told Medscape Medical News, “We welcome the addition of these Standards to the growing body of recent statements helping to position obesity medications as standard therapy in the comprehensive care of patients living with complicated overweight and obesity.”

The two sets of recommendations “are similar in their intended audiences, especially to reach providers, patients, payers, and policy makers so as to guide the use of US FDA-approved obesity medications, which might differ from other countries’ offerings. They both can support providers to engage in collaborative decision-making to promote comprehensive patient-centered obesity care, and they both aim to influence payors to reduce inequities in patient access and care,” said Purnell, an endocrinologist and obesity medicine specialist who is professor of medicine at Oregon Health & Science University, Portland, Oregon.

However, the methodology differed. The ADA Professional Practice Committee for Obesity performed systematic evidence reviews and graded the evidence. But the TOS/OMA/OAC authors actually used Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology “that rates the certainty of evidence and the strength of recommendations, focusing on the overall body of evidence for each outcome, not the outcomes or merits of individual studies…GRADE has become the most commonly used development tool for clinical practice guidelines globally,” Purnell said.

In addition, “the TOS/OMA/OAC guidance statement included the voices of patients with lived experience with obesity through their OAC representatives and will be the first guideline to elevate patient quality of life outcomes to be on par with efficacy of weight loss, cardiovascular outcomes, and total mortality,” he noted.

But there is likely to be general alignment, given that the ADA Obesity Association document was endorsed by TOS, OMA, and OAC, along with the American Board of Obesity Medicine Foundation. “We are glad our TOS members could substantially contribute to the final [ADA] product, which represent the most up-to-date evidence review so far,” Purnell said. 

The ADA Standards of Care is funded by ADA general revenue, and the authors were not paid for their participation. “Authors with relevant conflicts of interest were excluded from discussions or decisions related to specific recommendations to maintain the integrity of the guideline development process,” according to the document. Purnell has received consulting fees from Boehringer Ingelheim and Novo Nordisk. 

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 @MiriamETucker and BlueSky @miriametucker.bsky.social.