ATLANTA — Upcoming evidence-based clinical guidelines from three obesity organizations will address US-based pharmacologic management of overweight/obesity and its complications in adults.

The document will provide recommendations and summarize the evidence in the form of answers to 15 separate questions. The first eight will cover the use of orlistat, bupropion-naltrexone, phentermine, phentermine-topiramate, liraglutide, semaglutide, and tirzepatide for overweight/obesity and setmelanotide for certain monogenic obesity syndromes.

A preview of the new guidelines — which will be issued jointly by The Obesity Society, the Obesity Medicine Association, and the advocacy group Obesity Action Coalition — was presented by some of its authors at Obesity Week 2025, the meeting of The Obesity Society.

Previously, The Obesity Society had endorsed the Canadian guidelines on pharmacotherapy for obesity that were revised in August 2025. The most recent American guidelines were issued by the Endocrine Society in 2015.

Canada has “different medications approved than we do in the US, so we identified that we needed to do a US clinical practice guideline,” said Marc-Andre Cornier, MD, The Obesity Society president and professor of medicine and director of the Division of Endocrinology, Diabetes and Metabolic Diseases at the Medical University of South Carolina, Charleston, South Carolina.

“We followed all the most stringent guideline rules in terms of the evidence,” Cornier told Medscape Medical News.

The next five questions in the guidelines will deal with using medications for weight maintenance and using GLP-1 receptor agonists for obstructive sleep apnea, heart failure with preserved ejection fraction, metabolic dysfunction-associated steatotic liver disease/metabolic dysfunction-associated steatohepatitis, and osteoarthritis, the authors told meeting attendees.

Two final questions address the use of semaglutide specifically for people with a history of myocardial infarction, stroke, or symptomatic peripheral vascular disease and the use of FDA-approved obesity medications for people with type 2 diabetes.

Unique to these new joint guidelines will be “the incorporation of quality of life as an important metric, not just weight loss,” said Cornier. “The idea is to help the practitioner and the payers here in the US see the evidence for treating obesity with medical therapy.”

Once the document is published, the writing panel aims to follow it up with a practical best practice publication, which offer advice to clinicians on “how to take the evidence base from the guidelines and actually translate into clinical practice,” Cornier told Medscape Medical News.

Obesity Care Challenging to Implement

Asked to comment, obesity policy expert Theodore K. Kyle, RPh, founder and CEO of ConscienHealth, Pittsburgh, told Medscape Medical News, “The guideline process they’ve gone through is fabulous. But the challenge of implementing a guideline in obesity is great because there are so many forces that act against actually delivering care at scale to the many people who need it. So a lot of work lies ahead to make it happen.”

People will often say it’s not affordable to delivery obesity care to all who need it, Kyle lamented. “Can you imagine saying that with cancer or hypertension or heart disease? I cannot but people are ready to say that for obesity, probably because of implicit bias, the thought that sits in the back of our head that somehow these people are to blame for the health problems they are having.”

But Kyle also said he was “heartened” by the November 6, 2025, White House press briefing announcing that the price of some obesity drugs will be reduced and that they will now be covered by Medicare.

“There was so much said that is consistent with what’s being said here, that if we want to tackle chronic diseases, we have to tackle obesity. Absolutely true. And it’s encouraging to hear people say it.”

Cornier reported serving as an advisor and/or consultant for AstraZeneca, Biophytis, Eli Lilly, Keros, Novo Nordisk, Regeneron, Wave, and ZyVersa. Kyle reported being a consulting for Boehringer Ingelheim, Emerald Lake Safety, Novo Nordisk, Nutrisystem, and Roman Health Ventures.

Miriam E. Tucker is a freelance journalist based in the Washington, DC, area. She is a regular contributor to Medscape Medical News, with other work appearing in The Washington Post, NPR’s Shots blog, and diaTribe. She is on X @MiriamETucker and BlueSky @miriametucker.bsky.social.