November 28, 2023

The American Gastroenterological Association released a new set of evidence-based guidelines to support clinicians in choosing the best pharmacological interventions for patients with obesity (BMI 30 kg/m2).1

“These medications treat a biological disease, not a lifestyle problem. Obesity is a disease that often does not respond to lifestyle interventions alone in the long-term,” says author Eduardo Grunvald, MD, University of California San Diego in a press release. “Using medications as an option to assist with weight loss can improve weight-related complications like joint pain, diabetes, fatty liver and hypertension.”2

The following medications were recommended by the panel of experts:

  1. Semaglutide 2.4 mg
  2. Liraglutide 3.0 mg
  3. Phentermine-topiramate extended-release
  4. Naltrexone-bupropion extended-release

Each medication is recommended as an addition to lifestyle interventions, which aid in weight loss efforts for patients when compared to results seen with lifestyle interventions alone. The panel states that lifestyle interventions that include diet, physical activity, and behavior therapy are essential to an overweight or obesity prevention or treatment program.

Further, the panel suggested against the use of orlistat based, in part, on a meta-analysis of 20 randomized controlled trials, which showed that patients on orlistat had a higher incidence of treatment discontinuation due to adverse effects compared to controls. The panel also identified the use of Gelesis100 oral superabsorbent hydrogel as a knowledge gap.2

“As obesity is both a disease and a risk factor for other chronic illnesses, it is paramount to continue to assess the effect of weight loss using pharmacological interventions on important outcomes, such as cardiovascular events, nonalcoholic fatty liver disease, mortality, and cancer incidence and treatment response, among others,” the panel wrote. “Although weight and BMI are the measures patients and clinicians use to assess efficacy in the clinical setting, important benefits for health risks, longevity, quality of life, and cost-effectiveness are critical measures with current and emerging treatments.”


—Jessica Ganga


  1. Grunvald E, Shah R, Hernaez R, et al. AGA clinical practice guideline on pharmacological interventions for adults with obesity. Gastroenterology. 2022;163(5):1198-1225. doI:10.1053/j.gastro.2022.08.045.
  2. First medical guideline recommends new prescription medications for weight loss, ranks the most effective drugs. News release. MedicalXpress; October 20, 2022. Accessed November 10, 2022.


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