CALGARY, Canada – Six new and seven revised recommendations are now in play for adult obesity pharmacotherapy in Canada. The updated guideline, reflecting evidence through May 2025, offers a fresh look at how to manage weight with medication.
New Medications and Approaches Shape Obesity Care
Table of Contents
Canada’s latest obesity guideline incorporates new drugs and refined strategies for weight management.
- Initiate pharmacotherapy using central adiposity measures, ethnicity-specific BMI, and health complications.
- Combine obesity medications with health behavior changes, tailored to individual needs.
- Tirzepatide and setmelanotide are among the new medications included.
- Avoid compounded or non-approved weight loss medications.
What’s the latest guidance on using medications for obesity management in adults? Canada’s updated guidelines now include six new and seven revised recommendations, incorporating the most recent evidence available up to May 2025.
Extensive Review Guides Updates
The growth of these recommendations involved a deep dive into scientific literature. Researchers conducted a systematic review of studies on pharmacotherapy for weight management from January 2022 to July 2024. This was further bolstered by relevant trials published up to May 2025. Additionally, 13 targeted searches explored managing weight-related complications across various subpopulations facing adiposity-related health issues.These included conditions like cardiovascular disease, heart failure, prediabetes, obstructive sleep apnea, and osteoarthritis.
Expert and Patient Input
The guideline’s recommendations benefited from the insights of primary care physicians, obesity medicine specialists, and individuals with lived experience of obesity. Their feedback was crucial in shaping the practical advice offered.
key Recommendations for Practice
A notable takeaway is the emphasis on a multi-faceted approach to deciding on pharmacotherapy. Beyond Body Mass Index (BMI), measures of central adiposity and specific health complications, tailored to ethnicity, should guide the initiation of treatment. Crucially, obesity pharmacotherapy is best used in conjunction with health behavior changes and must be individualized to align with a person’s unique health needs, values, and preferences.
The updated guidelines notably include two new medications: tirzepatide and setmelanotide. these are newcomers compared to previous versions of the guideline, and there are also new recommendations specifically addressing obesity-related complications. The researchers strongly advise against the use of compounded medications or any drugs not officially approved for weight loss in individuals with excess adiposity.
Integrating Pharmacotherapy into Treatment
Obesity pharmacotherapy is recognized as one of three core pillars of treatment, as outlined in the comprehensive Canadian Adult Obesity Clinical Practice Guideline. The other essential pillars are behavioral and psychological approaches, alongside surgical options. Experts stress that obesity treatment should always be personalized,considering each person’s specific health requirements,values,and preferences.
Limitations and future Directions
Its significant to note the guideline’s limitations. It currently focuses only on medications approved within Canada. While other effective medications exist and are approved in different countries, they are not included in this particular guideline. Furthermore, with over 200 health complications linked to obesity, a comprehensive literature search for all of them was not feasible within the scope of this review.
The study,led by sue Pedersen,MD,an endocrinologist and obesity medicine specialist based in Calgary,was published online in the Canadian Medical Association Journal.
