Updated Clinical Guidelines on Pharmacotherapy for Obesity Management: CMAJ - Video

In a significant update to obesity care, a new set of clinical practice guidelines has emphasized that pharmacotherapy should be used not just for weight loss but to improve overall health outcomes in individuals living with obesity. The updated recommendations were published in the Canadian Medical Association Journal.

The 2025 update includes six new and seven revised recommendations, building on the previous 2022 and 2020 editions. Departing from a sole focus on body mass index (BMI), the guideline integrates other important markers such as waist circumference, waist-to-hip ratio, and waist-to-height ratio, all adjusted for sex and ethnicity when appropriate, along with the presence of obesity-related complications.

Led by Dr. Sue D. Pedersen, MD, endocrinologist and obesity medicine specialist in Calgary, the guidelines highlight a patient-centered, individualized approach to obesity treatment.

“Obesity pharmacotherapy is a safe and effective option to support long-term obesity care,” says Dr. Pedersen. “It is one of three pillars of treatment outlined in the full Canadian Adult Obesity Clinical Practice Guideline, with other pillars being behavioural and psychological and surgical approaches. Obesity treatment should always be tailored to each person’s specific health needs, values, and preferences. Recommendations also support sustained use of obesity pharmacotherapy as part of a long-term strategy to maintain improvements in health and quality of life.”

Notably, the new recommendations include the use of tirzepatide and setmelanotide, and address the management of obesity-related complications such as atherosclerotic cardiovascular disease, heart failure with preserved ejection fraction, and osteoarthritis. The guideline also advises against compounded obesity medications due to concerns over their safety, efficacy, and content quality.

Despite advancements, access to obesity treatment remains limited. The panel highlights that only Alberta currently recognizes obesity as a chronic disease, and barriers like stigma, cost, and inadequate insurance coverage continue to hinder access.

These updates aim to guide healthcare professionals in providing more equitable, evidence-based care and to reinforce the role of pharmacotherapy in improving both short- and long-term health outcomes for patients with obesity.

Reference: Pharmacotherapy for obesity management in adults: 2025 clinical practice guideline update, Sue D. Pedersen, Priya Manjoo, Satya Dash, Akshay Jain, Nicole Pearce, Megha Poddar CMAJ Aug 2025, 197 (27) E797-E809; DOI: 10.1503/cmaj.250502