Raghuveer Vedala, MD, is a clinical physician at the Norman Regional Health System.

Raghuveer Vedala, MD

Pediatrics, Retention, and Lifestyle Changes in Obesity

The Obesity Medicine Association (OMA) Annual Conference 2026, in San Diego, California, featured >80 scientific and educational sessions covering everything from nutrition, physical activity, clinical pharmacology, and practice management for 

 care. From major steps forward in incretin therapies to the release of the updated OMA Obesity Algorithm, this year’s meeting brought tons of new data to the forefront of endocrinology care.

In the fifth and final episode of a 5-part 

, Raghuveer Vedala, MD, and Shagun Bindlish, MD, discuss the most impactful headlines to come out of OMA 2026 – as well as how these findings can be applied to everyday obesity management and treatment.

The discussion shifts to evolving approaches to pediatric and adolescent obesity management alongside broader shifts in how clinicians define treatment success. The speakers note that while off-label use of tirzepatide is being seen in adolescents, longer-term pediatric trial data are still pending, with expectations that more definitive evidence may emerge in the coming years. In contrast, currently approved therapies for adolescents include Wegovy and Saxenda (for ages 12 and older). A key theme is the reframing of success in obesity care: rather than focusing solely on scale-based targets, clinicians are encouraged to recognize meaningful clinical improvements—such as better blood pressure control, reduction in diabetes risk, improved sleep apnea, and enhanced overall function—even when weight loss is modest (e.g., 5–10%).

The speakers emphasize that weight plateaus are expected and reflect physiologic “set point” dynamics rather than treatment failure. They stress the importance of individualized expectations, avoiding overly restrictive eating patterns that may lead to nutritional deficiencies or unhealthy relationships with food, and instead prioritizing sustainable dietary habits, smaller balanced meals, and careful titration of therapy to manage side effects. In older adults, the discussion shifts further toward preserving lean mass and function, highlighting the need for assessments such as DEXA scanning, grip strength, gait speed, and structured resistance exercise to prevent sarcopenia and maintain independence while treating obesity.

Finally, the conversation broadens to a systems-level perspective on obesity care. GLP-1–based therapies are framed as tools that support behavior change rather than replacements for lifestyle foundations such as nutrition quality, physical activity, and a healthy relationship with food. The speakers underscore that success should ultimately be measured by improvements in quality of life and functional capacity—“making the immobile mobile”—rather than weight alone. They also highlight the impact of stigma and access barriers, noting that bias can influence physiology and that loss of coverage can undermine patients’ belief in recovery. Resources from the Obesity Medicine Association are recommended to support clinicians in adopting evidence-based, patient-centered obesity management approaches.

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In the final segment of this 5-part HCPLive Special Report, experts recap the Obesity Medicine Association Annual Conference 2026.

OMA 2026 Recap: Pediatrics, Retention, and Lifestyle Changes in Obesity

GLP-1s in Conditions Beyond Obesity

The discussion centers on the expanding role of GLP-1 receptor agonists, particularly semaglutide, in obesity and related metabolic disease, and how recent clinical data are reshaping practice. A major focus is the ESSENCE trial in metabolic dysfunction–associated steatohepatitis (MASH), where semaglutide 2.4 mg demonstrated significant histologic benefit, with steatohepatitis resolution in roughly 63% of treated patients versus 34% with placebo. This has contributed to increased clinical confidence following accelerated regulatory action and updated guidance supporting GLP-1–based therapy in patients with obesity and MASH. The speakers emphasize that this is also helping unify care across specialties—endocrinology, hepatology, gastroenterology, and primary care—under a broader metabolic syndrome framework rather than siloed disease management.

Beyond weight loss, the conversation highlights emerging mechanistic insights suggesting GLP-1 therapies may exert direct cardiometabolic and anti-inflammatory effects. These include potential modulation of inflammatory pathways such as interleukin-6 signaling, which may help explain observed cardiovascular and renal benefits beyond what would be expected from weight reduction alone. At the same time, new safety considerations are discussed, including post-marketing signals related to psychiatric adverse events such as suicidality, which remain unconfirmed causally but are prompting closer monitoring and proactive patient counseling. Additional emerging adverse effects, such as dysesthesia and neuropathic-type sensations reported with higher-dose formulations, are also noted, reinforcing the importance of individualized risk–benefit assessment and surveillance.

The discussion then shifts to bariatric surgery as an enduring pillar of obesity treatment alongside pharmacotherapy. Updated BMI thresholds are reviewed (≥35 kg/m² regardless of comorbidity, or 30–34.9 kg/m² with metabolic disease), and the speakers emphasize that surgery remains highly effective, particularly for patients who do not tolerate or respond adequately to GLP-1 therapies. Practical perioperative considerations are highlighted, including evolving guidance on holding GLP-1 agents prior to surgery due to delayed gastric emptying and aspiration risk, as well as the potential role of preoperative liquid diets and point-of-care ultrasound assessment. Overall, the segment reinforces a patient-centered, multimodal approach in which medications, surgery, and lifestyle interventions are integrated rather than viewed as competing strategies.

In the fourth segment of this 5-part HCPLive Special Report, experts recap the Obesity Medicine Association Annual Conference 2026.

OMA 2026 Recap: GLP-1s in Conditions Beyond Obesity

The Side Effects of GLP-1s for Obesity

Vedala shifts the discussion from emerging oral formulations of GLP-1 therapies to a key concern in obesity medicine: the impact of weight loss medications on lean mass, particularly muscle. The speakers highlight that while GLP-1–based therapies can produce substantial weight loss, a meaningful portion may come from lean mass, raising concerns about sarcopenia, frailty, bone health, and long-term functional outcomes, especially among older adults and women. Bindlish and Vedala discuss findings from studies such as SEMALEAN, which suggested that a significant percentage of weight loss with semaglutide may involve lean mass, while emphasizing that adequate protein intake and resistance training are essential strategies to help preserve muscle. Early data from the BELIEVE trial evaluating bimagrumab combined with semaglutide was also discussed as a potential future approach to improving fat loss while maintaining lean mass, though the evidence remains preliminary.

The conversation emphasizes that obesity treatment should not rely solely on medication, particularly as more GLP-1 therapies and other agents enter the market. The clinicians expressed concern that many patients are obtaining weight-loss medications through online platforms or compounded sources without receiving appropriate counseling on nutrition, exercise, muscle preservation, or baseline assessments such as body composition measurements. They stressed that medications should be viewed as tools that complement, rather than replace, lifestyle interventions. Resistance exercise, protein optimization, and comprehensive obesity medicine evaluations should become standard components of care to support long-term health, function, and longevity.

In the third segment of this 5-part HCPLive Special Report, experts recap the Obesity Medicine Association Annual Conference 2026.

OMA 2026 Recap: The Side Effects of GLP-1s for Obesity

Oral Pharmacotherapy for Obesity

Vedala emphasizes that obesity treatment conversations require sensitivity, as many patients struggle to initiate discussions about weight due to stigma and fear. The speakers highlight concerns around discontinuation of GLP-1 therapies, noting that patients often experience significant anxiety about losing progress and regaining weight if coverage is interrupted. The conversation stresses the importance of clinician advocacy, including engagement with policymakers, to address access barriers and support long-term obesity management.

Vedala then shifts to emerging obesity pharmacotherapy, particularly the introduction of oral GLP-1 therapies and data from the ATTAIN trial. The speakers describe the newly approved oral, non-peptide GLP-1 medication as a potential shift in obesity treatment by offering an alternative to injectable therapies, with greater convenience and no fasting requirement. Trial data showed meaningful weight loss, with patients achieving an average reduction of around 11% and many reaching clinically important weight-loss thresholds. While injectable therapies such as tirzepatide and semaglutide remain the efficacy benchmarks, the availability of oral options may help address adherence, needle aversion, and access challenges.

Bindlish and Vedala then discuss how oral GLP-1 therapies may change the way clinicians approach obesity as a chronic disease, similar to other conditions managed with daily oral medications. The speakers note that patients appear increasingly receptive to oral options, but clinicians must continue educating patients about gastrointestinal side effects, which remain an important consideration. Because daily oral dosing may require more attention to meal timing, eating patterns, and symptom management, they emphasize the need for ongoing patient counseling as these therapies become more widely used.

In the second segment of this 5-part HCPLive Special Report, experts recap the Obesity Medicine Association Annual Conference 2026.

Raghuveer Vedala, MD

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