Beyond GLP-1s: The next chapter of obesity care
The rapid rise of GLP-1 medications such as semaglutide and tirzepatide has transformed obesity treatment. Still, experts say medications alone are not enough to address one of the nation's most pressing chronic diseases.
A new commentary published in the American Gastroenterological Association’s journal Gastroenterology, "Revisiting POWER in the GLP-1 Age," updates the landmark POWER (Practice Guide on Obesity and Weight Management, Education, and Resources) framework first published in 2017. The paper reflects major advances in obesity care, including the emergence of highly effective anti-obesity medications, new evidence supporting endoscopic bariatric and metabolic therapies, expanded indications for bariatric surgery, and advances in precision medicine.
Key takeaways:
- GLP-1 receptor agonists have fundamentally changed the treatment landscape for obesity.
- The commentary incorporates the emerging concept of clinical obesity, which recognizes obesity as a chronic, systemic disease and highlights the limitations of relying on body mass index alone to assess health risks.
- Obesity care is increasingly moving toward a multidisciplinary model that combines medications, endoscopic therapies, and surgery.
- New evidence supports endoscopic sleeve gastroplasty and other endoscopic bariatric and metabolic therapies as effective treatment options.
- Advances in genetics and precision medicine may help physicians better match patients with obesity treatments that are most likely to be effective.
- Combining GLP-1 medications with endoscopic or surgical interventions may produce greater and more durable weight loss than either approach alone.
The paper emphasizes the important role gastroenterologists and hepatologists play in obesity management. These specialists routinely care for patients with obesity-related conditions such as metabolic dysfunction-associated steatotic liver disease (MASLD), gastroesophageal reflux disease (GERD), gallbladder disease, and gastrointestinal complications associated with obesity.
Reference:
Acosta A, Gunaratnam N, Popov V ...Revisiting POWER in the GLP-1 AgeGastroenterology, 2026; DOI:10.1053/j.gastro.2026.04.016
