The European medical association has issued new guidelines recommending Novo Nordisk's semaglutide and Eli Lilly's tirzepatide as first-line treatments for obesity, citing their high effectiveness in weight loss and managing related complications.

These guidelines, published in Nature Medicine, suggest other medications like liraglutide, naltrexone–bupropion, and phentermine-topiramate for less severe cases or when specific needs are present.

The recommendations specify drug choices based on obesity-related complications, such as using tirzepatide for obstructive sleep apnea and semaglutide for knee osteoarthritis.

While these medications are costly, early intervention is considered economically justified because it prevents long-term complications and organ damage, reducing overall healthcare costs.

Cost and limited NHS coverage remain barriers, with drugs like tirzepatide not covered in some regions and others available only privately at high monthly costs.

Personalized treatment approaches are emphasized, considering factors like disease severity, comorbidities, socioeconomic status, and patient preferences, with plans to update the guidelines as new evidence and drugs emerge.

Obesity treatment is multifactorial, involving both pharmacological and non-pharmacological strategies, with clinical judgment playing a crucial role in individualizing therapy.

Experts highlight that incretin therapies like semaglutide and tirzepatide are revolutionary, but their heterogeneity in patient responses requires careful clinical judgment.

Obesity treatment should aim not only for weight loss but also for improving mental health, physical fitness, social functioning, and overall quality of life.

Although evidence for treating specific complications beyond weight loss is limited, ongoing research suggests potential benefits of these drugs for conditions like kidney disease, neurodegenerative disorders, and certain cancers.

Healthcare providers warn that rapid broad distribution of these drugs could overwhelm systems like the NHS, emphasizing the importance of clinical judgment and economic considerations.

The European Association for the Study of Obesity plans to regularly update these guidelines to incorporate new evidence and evolving treatments in the field of obesity pharmacotherapy.