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It’s been an exciting year in obesity medicine! While we have summited some big peaks this year, we have many mountains yet to conquer (being a Canadian mountain girl, of course this is the analogy I will choose 🙂 ).
Right at the center of the entire field is a ton of debate and disagreement on how to diagnose obesity in the first place. While guidelines and guidances from organizations around the world generally agree that we need to look beyond BMI to include waist-based measures of central body fat, further staging/defining/refining/classification remains hotly debated.
Many guidelines, consensus, and guidance articles have come out this year on how to treat obesity. Top of this list, Obesity Canada has published a comprehensive 2025 Clinical Practice Guideline on how to use obesity medications (disclosure: I am the lead author) – check out my blog post for a summary of what is new (and it’s a lot!!) since our last guideline published just 3 years prior. The European Association for the Study of Obesity has published a framework on this topic as well.
Clinical learnings are further shaping our best use of weight management medications. There is a clear need to reshape thinking of society in general that, for safety reasons, the biggest, fastest possible weight loss is NOT the appropriate goal (even more on this here). With more highly effective weight management medications available and emerging, we need more data to inform us on possible vitamin deficiencies that could arise, and whether/what we should consider for vitamin supplementation. We have drawn much-needed attention to other medications that may need adjusting when you’re taking weight loss medication. What to do with GLP1 medications around the time of surgery or conscious sedation remains unclear.
Many exciting developments are paving the way for new potential obesity medications, such as amylin agonists with GLP1 or as standalone treatment, GLP1s in a pill format instead of injectable, dual GLP1/glucagon agonism, once a month treatment with GLP1 agonist/GIP antagonist, and the ‘triple G’ approach (GLP1/glucagon/GIP agonist).
A huge question which I suspect will dominate in 2026, will be how to navigate the onslaught of online weight management platforms that are emerging all over the world. Not only is it important to include consideration of these checkpoints if you are choosing an online platform that prescribes treatment, but as AI proliferates, it will be important to understand if a human or a computer is doing your prescribing, and what safety pitfalls may exist in that paradigm.
I’m buckled in and ready for an exciting year ahead! Stay tuned to my blog for new developments.
A heartfelt thank you to all my readers and listeners out there, and a very Happy Holidays to all!
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