Pharmacologic Treatment of Obesity in Adults: Standards of Care in Overweight and Obesity

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. Health care 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 health care professionals to adopt these guidelines for treatment of obesity in adults.

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. 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, 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. Participants treated with obesity medications also had improvements in cardiometabolic markers, such as glycemia and lipid profiles, and some obesity medications demonstrated improvements in cardiovascular outcomes and other obesity-related diseases. When used appropriately, obesity medications offer a favorable risk-benefit profile in many cases, making them a viable option for many people with obesity.

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