Canada has released updated guidelines for obesity pharmacotherapy in adults, which include six new and seven revised recommendations based on evidence gathered up to May 2025.

Published in the Canadian Medical Association Journal, the updated pharmacotherapy guideline emphasizes the importance of individualized treatment plans for obesity management.

These guidelines reflect a shift in focus from traditional body mass index (BMI) measures to additional indicators such as waist circumference and waist-to-hip ratio.

Notably, the guidelines introduce two new medications, tirzepatide and setmelanotide, along with guidance for managing obesity-related complications like cardiovascular disease and osteoarthritis.

Obesity pharmacotherapy is recognized as one of the three primary treatment pillars, alongside behavioral/psychological and surgical approaches.

The guidelines recommend that pharmacotherapy be used in conjunction with health behavior changes and tailored to individual health needs and preferences.

Importantly, the guideline advises against the use of compounded medications or non-approved weight loss drugs due to safety concerns.

The authors stress that the lack of recognition of obesity as a chronic disease impacts treatment access, calling for broader recognition to enhance patient support.

Currently, only Alberta recognizes obesity as a chronic disease, and various barriers, including cost, stigma, and limited drug coverage, hinder access to treatment for many Canadians.

The development of these guidelines involved feedback from primary care physicians, obesity specialists, and individuals with lived experience of obesity.

New recommendations also emphasize the use of measures of central adiposity and ethnicity-specific BMI to guide pharmacotherapy decisions.

The updated guidelines were developed through a systematic review of literature from January 2022 to July 2024, incorporating trials published through May 2025.