Today, we are outlining key recommendations from The Obesity Society (TOS), Obesity Medicine Association (OMA), and Obesity Action Coalition (OAC) guideline, Pharmacological Management of United States Adults With Overweight or Obesity. In the United States, obesity affects over 40% of adults, with rates of severe obesity continuing to rise. Though obesity is recognized as a chronic disease, it remains undertreated and undiagnosed, with many patients facing barriers to effective care. This new guideline provides evidence-based recommendations on the pharmacological management of US adults with overweight or obesity, with the goal of improved quality of life, weight reduction, and reducing obesity-related complications.

Outlined below, we feature the fifteen recommendations discussed in the new TOS, OMA, OAC guideline. View the full-text version for the most thorough explanation of these recommendations.

Recommendations from the 2026 TOS, OMA, OAC Pharmacological Management of U.S. Adults with Overweight or Obesity Guideline

FDA-Approved Medications for Use in Adults with Obesity: 

  • TOS, OMA, and OAC suggest using orlstat in adults aged 18 years or older with overweight or obesity. 
  • TOS, OMA, and OAC recommend using bupropion-naltrexone in adults aged 18 years or older with overweight or obesity. 
  • TOS, OMA, and OAC suggest using phentermine for 3 months or more in adults aged 18 years or older with overweight or obesity.
  • TOS, OMA, and OAC suggest using phentermine-topiramate in adults aged 18 years or older with overweight or obesity.
  • TOS, OMA, and OAC suggest using liraglutide in adults aged 18 years or older with overweight or obesity.
  • TOS, OMA, and OAC recommend using semaglutide in adults aged 18 years or older with overweight or obesity.
  • TOS, OMA, and OAC recommend using tirzepatide in adults aged 18 years or older with overweight or obesity.
  • TOS, OMA, and OAC recommend using setmelanotide in adults aged 18 years or older with monogenic obesity syndromes (e.g., risk alleles for LEPR, POMC, PCSK1, and BBS).

Role of Obesity Medications in the Weight Maintenance Phase:

  • TOS, OMA, and OAC recommend continuing obesity medications in adults undergoing medical obesity treatment during the weight maintenance phase, compared with not continuing obesity medications.

Role of Obesity Medications in the Prevention and Management of Obesity Complications: 

  • TOS, OMA, and OAC suggest using GLP-1 receptor agonists or GLP-1/GIP receptor dual agonists in adults aged 18 years or older with obstructive sleep apnea (OSA).
  • TOS, OMA, and OAC suggest using GLP-1 receptor agonists or GLP-1/GIP receptor dual agonists in adults aged 18 years or older with heart failure with preserved ejection fraction (HFpEF).
  • TOS, OMA, and OAC suggest using GLP-1 receptor agonists or GLP-1/GIP receptor dual agonists in adults aged 18 years or older to reduce liver fat and treat metabolic dysfunction-associated steatohepatitis (MASH).
  • TOS, OMA, and OAC suggest using GLP-1 receptor agonists compared to lifestyle interventions/placebo in adults aged 18 years or older with osteoarthritis.
  • TOS, OMA, and OAC suggest using semaglutide in adults aged 18 years or older with a history of myocardial infarction, stroke, or symptomatic peripheral vascular disease.
  • TOS, OMA, and OAC suggest using FDA-approved obesity medications in adults aged 18 years or older with type 2 diabetes.

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