A new review in Gastroenterology examines the current and emerging treatment landscape for obesity, covering anti-obesity medications, endoscopic bariatric and metabolic therapies, and bariatric surgery. The authors note that while lifestyle therapy alone generally produces modest weight loss, newer pharmacologic, endoscopic, and surgical approaches can produce substantially greater weight loss.
The review also focuses on a major implementation challenge: despite the availability of effective therapies, obesity treatment remains limited by cost, inadequate insurance coverage, and insufficient access to clinicians who can prescribe medications or perform endoscopic and surgical procedures. The authors argue that gastroenterologists are particularly well positioned to help address this gap because many of the newer obesity therapies target the gut or gut-hormone pathways.
The paper covers practical considerations for obesity-management medications, endoscopic bariatric and metabolic therapies, and bariatric/metabolic surgery. It also discusses newer therapies in the pipeline, including oral semaglutide and oral GLP-1 receptor agonists, alongside established approaches.