Living guideline presents pharmacologic treatments that are recommended with lifestyle modifications for weight management
MONDAY, June 22, 2026 (HealthDay News) — In a new living clinical guideline issued by the American College of Physicians and published online June 16 in the Annals of Internal Medicine, recommendations are presented for the pharmacologic treatment of overweight and obesity in adults.
Amir Qaseem, M.D., Ph.D., from the American College of Physicians in Philadelphia, and colleagues examined systematic reviews of pharmacological treatments in adults with overweight and obesity to develop clinical guidelines for internal medicine and other clinicians caring for adults with overweight or obesity in outpatient settings.
According to the guidelines, for nonpregnant adults with obesity in outpatient settings, one of the pharmacologic treatments should be initiated with lifestyle modifications for weight management; first-line treatments are semaglutide and tirzepatide; second-line treatment is phentermine-topiramate; third-line treatment is liraglutide; and naltrexone-bupropion is fourth-line treatment. Clinicians and patients should discuss benefits, harms, costs, access and availability, clinical comorbidities, weight loss goals, life expectancy, values and preferences, and contraindications and warnings when initiating a recommended medication or switching to another medication due to inadequate response. For nonpregnant adults with overweight and type 2 diabetes, dyslipidemia, hypertension, obstructive sleep apnea, or cardiovascular disease, recommended pharmacologic treatments are semaglutide and tirzepatide (first-line) and liraglutide (second-line).
“Future research should evaluate pharmacologic treatment for its ability to prevent obesity, for weight management without lifestyle modifications, and immediately after bariatric surgery,” the authors write.
Abstract/Full Text — Review 1 (subscription or payment may be required)
Abstract/Full Text — Review 2 (subscription or payment may be required)
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