The white paper spurred widespread adoption of the POWER program by academic and private gastroenterology and hepatology practices, many of which have used it as a guide for implementing a multidisciplinary obesity care model.2 The aim of this commentary is to provide a comprehensive update of POWER in light of several important developments in the fields of obesity and cardiometabolic diseases in recent years, including the following:
- Market entry of newly approved antiobesity medications (AOMs), including the glucagon-like peptide-1 receptor agonists (GLP-1RAs) semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound, Mounjaro).3
- Several notable publications on endoscopic bariatric and metabolic therapies (EBMTs), including a report from the MERIT trial, in which endoscopic sleeve gastroplasty (ESG) was found to be safe and effective in inducing significant, sustained weight loss in a randomized multicenter trial.4
- New indications for metabolic and bariatric surgery (MBS), building upon extensive previous data demonstrating safety and effectiveness.5
- Advances in understanding the genetics of obesity to predict response to diets6 and medications.7
- An AGA Obesity Episode of Care and Bundle Initiative Work Group white paper, which introduced the episode-of-care model to engage specialists in the movement toward fee for value, while facilitating improved outcomes and patient experience and reducing unnecessary services and overall costs.8
- A 2024 estimate from the Congressional Budget Office, which forecast increased federal spending on AOMs by roughly $35 billion from 2026 to 2034, including an increase of $1.6 billion to $7.1 billion in total direct costs for covering AOMs by 2034.9