Endocrine Society Scientific Statement: Improved health should guide obesity treatment, not weight loss alone
A new Scientific Statement released by the Endocrine Society highlights the benefits of obesity treatment beyond weight loss, including improvements in overall health and reducing the risk of conditions such as heart disease, sleep apnoea and liver disease.
Obesity is a complex, chronic disease influenced by biology, genetics, metabolism, the brain, and environmental factors, not simply a matter of willpower. The disease affects over 40% of American adults and costs over $173 billion annually in US obesity-related medical care costs.
“This Statement highlights major advances in obesity science and outlines areas of research needed to improve our understanding of the disease, optimize treatment, personalize care and improve long-term health outcomes for people living with obesity,” said Dr Daniel J Drucker, Mount Sinai Hospital in Toronto, Ontario, Canada, lead author of the Scientific Statement writing group. “The rapid adoption of highly effective obesity medications has changed the treatment landscape, but important questions remain about their long-term use, individualised treatment strategies, side effects and the best ways to measure treatment outcomes.”
The statement outlines what researchers know, what they still need to learn and where future research on obesity should focus.
Semaglutide, tirzepatide and other GLP-1 based therapies have transformed obesity treatment and helped us better understand the disease. They are now being used not only for treatment of overweight and obesity, but also for improving comorbidities including heart disease, sleep apnoea, kidney and liver disease, and being investigated for other diseases such as cancer, substance use disorders, arthritis and infertility.
If left untreated, obesity can cause poor metabolic and mental health, and a reduced ability to perform the basic physical tasks and movements needed for everyday living.
However, there are safety considerations with GLP-1s including the medications' direct effects, consequences of rapid weight loss, and areas where long-term risks and outcomes remain uncertain.
Research supports that obesity is a chronic disease that requires long-term treatment. People with obesity who stop treatment after reaching their goal weight often gain it back and experience worsening of other health issues such as blood pressure, cholesterol and blood sugar levels.
Studies show that people can maintain much of their weight loss when transitioning to lower-dose therapies or different medications after initial treatment.
The Statement identifies these key questions and priorities for future research on obesity:
How the body regulates and store fat
Why obesity manifests differently in individuals and how this affects treatment
Redefining treatment targets beyond weight loss
How the body responds to anti-obesity medications over time
Health outcomes with anti-obesity medications
How safe new anti-obesity medications are for long-term use
“Advancing research across these six priority areas will help transform obesity care by deepening our understanding of disease biology, improving treatment precision, defining meaningful clinical outcomes and optimizing the safe and effective use of emerging therapies,” Drucker said. “We need larger, longer and more diverse studies, as well as greater use of real-world data to understand treatment outcomes.”
The Endocrine Society develops Scientific Statements to explore the scientific basis of hormone-related conditions and diseases, discuss how this knowledge can be applied in practice and identify areas that require additional research. Topics are selected on the basis of their emerging scientific impact. Scientific Statements are developed by a Task Force of experts appointed by the Endocrine Society, with internal review by the relevant Society committees and expert external reviewers prior to a comment period open to all members of the Society.
The Scientific Statement is part of the Society's Center on Obesity, a broader initiative to advance obesity research and care.
The statement, ‘Obesity Science, Research Gaps, and Opportunities in the New Era of Obesity Medicines - an Endocrine Society Scientific Statement,” was published online in the Society’s journal, Endocrine Reviews. To access this paper, please click here
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