ADA’s Obesity Association Releases Guidelines for Use of Obesity Medications

On January 13, 2026, the Obesity Association, a division of the American Diabetes Association, published the next section in the Standards of Care in Overweight and Obesity, titled “Pharmacologic Treatment of Obesity in Adults,” in the inaugural edition of Diabetes, Obesity, and Cardiometabolic CARE.”1

The 23-page document spotlights pharmacotherapy’s role in reducing weight and improving weight maintenance compared to placebo, citing several clinical trials to support the drugs’ efficacy compared to placebo. However, the authors also stress the value of patient-centered shared decision-making in prescribing medication, encouraging a focus on each patient’s individual needs.1,2

“The establishment of the Obesity Association, and now its associated journal, marks a significant advancement toward a future where the management of cardiometabolic diseases is unified, proactive, and grounded in a thorough understanding of their biological origins,” Samar Hafida, MD, vice president of the Obesity Association, said in a statement. “Through the Standards of Care in Overweight and Obesity, we continue to build the body of trusted, evidence-based guidelines in obesity care.”1

The guidelines suggest that a reduction in baseline body weight of ≥5% for adults treated with obesity medications shows significant health benefits and improvements in cardiometabolic risk factors. For patients with obesity-related diseases and complications, however, the authors encourage a reduction of ≥10% in baseline body weight, while a 10-15% reduction resulted in improvements in glycemia, blood pressure, and lipids compared to a 5-10% loss. Additionally, the guidelines highlight emerging data that suggest that ≥15% weight reduction may be required in some cases.2

The document goes on to highlight commonly weight-promoting medications for conditions such as diabetes and hypertension, providing alternative treatment suggestions to avoid excess weight gain. For example, the authors suggest replacing hypertension medications such as alpha blockers, metoprolol, propranolol, and atenolol with ACE inhibitors, ARBs, carvedilol, thiazides, and nebivolol.2

Additionally, the guidelines emphasize the value of intensive behavioral therapy or structured lifestyle programs, as combining lifestyle changes with medication results in consistently greater weight reduction and health benefits. Nutritional counseling is also listed as a crucial factor in obesity management, particularly for patients on obesity medications. This is due in large part to the appetite-suppressing mechanics central to many treatment options, which may leave patients susceptible to inadequate nutrition through diminished hunger and its effects.2

The authors also state that individuals with limited or partial responses to a given medication may be able to combine this medication with another, so that health care providers can target different pathways of weight regulation. Low-dose combination therapy has shown comparatively greater weight reduction than high-dose monotherapy in several randomized control trials.2

Notably, the guidelines also spotlight obesity management during pregnancy, specifying that all approved obesity medications are currently contraindicated in patients who are pregnant or are actively trying to conceive. Some medications have been associated with fetal harm, such as topiramate, which is associated with major congential malformations. To this end, the guidelines suggest that patients considering pregnancy stop obesity medication ≥2 months prior to a planned pregnancy, accompanied by intensification of lifestyle behavioral therapy to accommodate.2

Ultimately, these recommendations align with the Obesity Association’s broader work, which aims to change the conversation on obesity care and recognize obesity as the complex disease it is.1

“The ADA’s Obesity Association encourages health care professionals to adopt and implement the present recommendations on obesity medications as part of a comprehensive obesity treatment plan for adults,” the ADA Professional Practice Committee for Obesity wrote. “Evidence supports the use of obesity medications in combination with lifestyle interventions to achieve long-term health and weight reduction goals.”2

References

1. American Diabetes Association. The Obesity Association Publishes New Standards of Care Section on Obesity Medications. PRNewswire. January 13, 2026. Accessed January 13, 2026. https://www.prnewswire.com/news-releases/the-obesity-association-publishes-new-standards-of-care-section-on-obesity-medications-302659817.html

2. American Diabetes Association Professional Practice Committee for Obesity*; Pharmacologic Treatment of Obesity in Adults: Standards of Care in Overweight and Obesity. DOCM CARE 2026; doci250008. https://doi.org/10.2337/doci25-0008