Obesity groups issue strong recommendation for semaglutide, tirzepatide and continuing medication in maintenance

The Obesity Society, the Obesity Medicine Association and the Obesity Action Coalition issued a joint guidance statement that gives strong recommendations for semaglutide and tirzepatide in US adults with overweight or obesity, along with a separate strong recommendation that obesity medications be continued during weight maintenance ^[1][2].

The statement was published March 5, 2026, in the journal Obesity, volume 34, issue 4, pages 851–870, and appears in Obesity Pillars as well, with only minor style differences between the two versions ^[2]. A multidisciplinary panel that included patient representatives and obesity care providers developed it using the GRADE approach, with systematic evidence synthesis through Epistemonikos databases and consensus workshops ^[1][2]. Recommendations were graded strong or conditional based on evidence certainty, benefits, harms, equity and feasibility, and the panel prioritized outcomes including weight reduction, quality of life, adverse events and improvements in obesity complications ^[1][2].

Strong recommendations went to bupropion-naltrexone, semaglutide, tirzepatide and setmelanotide, all supported by moderate-certainty evidence ^[1][2]. Conditional recommendations covered other medications the panel reviewed — orlistat, phentermine, phentermine-topiramate and liraglutide — and specific obesity complications: obstructive sleep apnea, heart failure with preserved ejection fraction, metabolic dysfunction-associated steatotic liver disease and steatohepatitis, osteoarthritis, major adverse cardiovascular events and type 2 diabetes ^[1][2].

The authors write that obesity affects more than 40% of US adults, with severe obesity on the rise, and that the condition remains underdiagnosed and undertreated despite being recognized as a chronic disease ^[1][2]. Barriers to treatment listed in the statement include socioeconomic disparities, limited clinician training, stigma, and restrictive or absent reimbursement policies ^[1][2].

Among the statement's messages for patients: obesity is not a failure of willpower but a chronic medical condition with safe and effective treatments beyond lifestyle alone ^[2]. For health care providers, it says that stopping comprehensive obesity care, including medications, without a cause such as side effects or pregnancy can follow from misunderstanding obesity as a chronic disease, and that this often leads to treatment failure and worsens bias and stigma directed at patients ^[2]. Obesity medications are described as safe and effective when used long term ^[2].

Funding came from the three organizations. Co-authors from CPG Direct supported coordination of the process — methodology, evidence synthesis, project support and writing — but did not take part in selecting questions or in the discussions that determined recommendations ^[1]. Participants disclosed financial and nonfinancial interests, and members with significant direct financial conflicts could discuss evidence but not judge or vote; no recusals were made ^[1].

Why it matters for patients

The statement's conclusions single out coverage as a practical problem, saying that expanding access, reducing stigma and ensuring equitable coverage are essential to turning research advances into population health gains ^[1][2]. For someone already taking semaglutide or tirzepatide, the guidance classifies maintenance treatment — staying on medication after weight loss rather than stopping it — as a strong recommendation, not a conditional one, and describes obesity medications as appropriate for long-term use ^[1][2].

The document also puts several common obesity-related conditions, including obstructive sleep apnea, major adverse cardiovascular events and type 2 diabetes, in the conditional category rather than the strong one, meaning the panel saw the evidence for those specific uses as less certain than for weight reduction itself ^[1][2].

Specific weight-maintenance percentages, cost figures and dose information are not included in the published abstract, and the guidance does not address what patients should do if a plan declines coverage ^[1][2].

What happens next

The statement lists future priorities: expanding access to and integration of comprehensive obesity care in primary care, improving affordability, addressing research gaps, conducting head-to-head trials, and updating the guidance as evidence evolves ^[1][2]. No date for an updated version has been disclosed ^[1][2]. A correction was added to the online article on March 7, 2026, correcting a co-author's name ^[2].