Ozempic changed obesity treatment, but experts say the real revolution is next

Weight-loss drugs like Ozempic and Zepbound have reshaped obesity treatment, but experts say they are only part of the solution.

The popularity of GLP-1 medications such as semaglutide (Ozempic, Wegovy, and Rybelsus) and tirzepatide (Mounjaro and Zepbound) has dramatically reshaped the way obesity is treated. However, specialists say these drugs are only one piece of the puzzle when it comes to managing one of the most widespread chronic health conditions in the United States.

A new commentary in the American Gastroenterological Association journal Gastroenterology revisits the influential POWER (Practice Guide on Obesity and Weight Management, Education, and Resources) framework, originally introduced in 2017. Titled "Revisiting POWER in the GLP-1 Age," the update reflects major developments in obesity care, from the arrival of highly effective weight loss medications to advances in endoscopic therapies, broader use of bariatric surgery, and the growing role of precision medicine.

Obesity Treatment Is Expanding Beyond Medication

According to the authors, GLP-1 receptor agonists have significantly changed the obesity treatment landscape. At the same time, they emphasize that obesity care is becoming increasingly comprehensive, combining medications with endoscopic procedures and surgical options when appropriate.

The updated framework also incorporates the emerging concept of clinical obesity. This approach recognizes obesity as a chronic disease that affects multiple body systems and highlights the limitations of relying solely on body mass index (BMI) to evaluate health risks.

Researchers note that obesity treatment is increasingly moving toward a multidisciplinary model that brings together different therapeutic approaches. Rather than viewing medications, procedures, and surgery as separate strategies, experts see them as complementary tools that can be tailored to individual patients.

New Evidence Supports Endoscopic Therapies

The commentary highlights growing evidence for endoscopic bariatric and metabolic therapies, including endoscopic sleeve gastroplasty, as effective treatment options for obesity.

The authors also point to advances in genetics and precision medicine that could help physicians identify which treatments are most likely to benefit specific patients. As researchers learn more about the biological factors that influence obesity, treatment plans may become increasingly personalized.

Another promising area involves combining therapies. Evidence suggests that pairing GLP-1 medications with endoscopic procedures or bariatric surgery could lead to greater weight loss and longer-lasting results than either approach alone.

The Role of Gastroenterologists in Obesity Care

The paper also underscores the important role gastroenterologists and hepatologists play in treating obesity and its related health complications.

These specialists frequently care for patients with obesity-associated conditions, including metabolic dysfunction-associated steatotic liver disease (MASLD), gastroesophageal reflux disease (GERD), gallbladder disease, and a range of gastrointestinal complications linked to obesity. Because of this close involvement, the authors argue that gastroenterologists and hepatologists are well positioned to help guide the future of obesity management as treatment options continue to evolve.