Incretin-based pharmacotherapy has redefined obesity medicine, with semaglutide 2.4 mg (Wegovy) and tirzepatide (Zepbound) now delivering 15–22% mean weight loss in the STEP and SURMOUNT programs.
Bariatric and metabolic surgery remains the most durable intervention for class II–III obesity, with 10–20 year data from RYGB and sleeve gastrectomy demonstrating sustained weight loss, diabetes remission, and reduced all-cause mortality.
Pediatric obesity affects nearly one in five US children and is now treated as a chronic disease in the 2023 AAP Clinical Practice Guideline, which endorses intensive health behavior and lifestyle treatment from age 6, pharmacotherapy from age 12, and surgery evaluation from age 13.
The leptin–melanocortin pathway underpins both rare monogenic obesity and emerging precision therapies.
Cardiovascular-Kidney-Metabolic (CKM) syndrome, formalized by the AHA in 2023, reframes obesity, insulin resistance, MASLD, CKD, and ASCVD as a single pathophysiologic continuum.
Even in the GLP-1 era, intensive lifestyle therapy remains foundational and amplifies pharmacologic and surgical outcomes.
The gut microbiome is increasingly understood as a metabolic organ regulating energy harvest, bile acid signaling, and incretin secretion.
The promise of GLP-1 therapeutics has thrown disparities into sharp relief: list prices exceed $1,000 per month, Medicare Part D coverage remains restricted to cardiovascular and MASH indications, and Black, Hispanic, and rural patients are underrepresented in both clinical trials and prescribing.
Population-level prevention has gained renewed urgency as ultra-processed foods now supply over half of US caloric intake.
Maintaining weight loss after GLP-1 discontinuation is a central clinical challenge defining the next phase of obesity medicine.
GLP-1 era creates new eating-disorder screening and management demands across obesity practice.
Sarcopenic obesity drives functional decline in older adults with growing recognition in the GLP-1 era.
Hormonal mechanisms underpin many obesity phenotypes with specific actionable therapies.
Obesity drives cardiovascular and metabolic complications with multiple GLP-1 outcome trials reshaping practice.
Obesity drives MASH progression with multiple new therapies entering clinical practice.
Sleep loss and sleep apnea drive obesity and complicate management with major recent trial readouts.
Population-level prevention requires institutional support with growing evidence base.
The obesity pharmacotherapy pipeline is the most active in medicine with multiple late-stage candidates.
Type 1 diabetes care has been transformed by closed-loop systems and disease-modifying therapy with growing recognition of beta-cell preservation.
T2D management has been reshaped by GLP-1 and SGLT2 therapies with growing personalisation.
Diabetic retinopathy screening and treatment have advanced with AI tools and longer-acting biologics.
Diabetic neuropathy spans painful, autonomic and large-fibre forms with new pharmacotherapy emerging.
DKD management has been transformed by SGLT2i and finerenone with the triplet therapy emerging.
PCOS care benefits from new pharmacotherapy and lifestyle approaches with growing GLP-1 evidence.
Thyroid disease intersects obesity care with multiple commonly-believed myths needing evidence-based clarification.
Insulin resistance underpins multiple cardiometabolic conditions with growing assessment options.
Lipid metabolism in obesity and metabolic syndrome differs from primary dyslipidemia with specific management.
Body composition assessment goes beyond BMI with growing evidence-based methods.
Body image and mental health intersect obesity care throughout treatment with persistent stigma considerations.
Pre-existing and gestational diabetes care has advanced with technology and the GLP-1 timing question.
Telemedicine has reshaped obesity care access with rapid post-pandemic expansion.
Endocrine-disrupting chemicals may contribute to obesity with growing epidemiological and mechanistic evidence.
Health coaching is increasingly evidence-based and reimbursable in obesity care.
Obesity in older adults requires careful management balancing benefit and risk.
Weight stigma harms patient outcomes across healthcare settings.