Wegovy, Zepbound named first choice for obesity treatment in new guidelines

• New clinical guidelines from the American College of Physicians (ACP) recommend semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound, Mounjaro) as first-line medications for adults with obesity.
• Using available evidence, the ACP ranked obesity medications, placing semaglutide and tirzepatide first, followed by phentermine-topiramate, liraglutide, and naltrexone-bupropion for adults with obesity.
• The guidance notes that treatment decisions should consider more than weight loss alone, including potential benefits and harms, cost, medication availability, comorbidities, patient preferences, and long-term health goals.
• The ACP also highlights that the recommendations are a ‘living guideline’, which will be regularly updated as new research emerges.

Obesity and overweight affect a growing proportion of adults worldwide, with global estimates suggesting that 43% of adults are living with overweight and 16% with obesity. In the United States, estimates indicate that 40.3% of American adults are living with obesity, and nearly three-quarters of adults are living with overweight or obesity.

Having excess weight is associated with an increased risk of conditions such as type 2 diabetes, high blood pressure, cardiovascular disease, and some cancers.

In recent years, newer weight-loss medications, particularly those belonging to the glucagon-like peptide-1 (GLP-1) receptor agonist class and related therapies, have transformed obesity treatment. However, questions have remained about how clinicians should prioritize the growing number of available options.

Now, new clinical guidelines from the American College of Physicians (ACP) recommend the medications containing semaglutide, such as Ozempic and Wegovy, and tirzepatide, such as Mounjaro and Zepbound, as the preferred first-line drug treatments for adults with obesity, when used alongside lifestyle changes.

The guidance, published in the Annals of Internal Medicine, alongside a patient summary, is designed to help physicians navigate the rapidly evolving landscape of obesity medications. The ACP has designated the document a ‘living guideline,’ noting they will update the guidance as new evidence emerges.