An expert panel is developing a framework for pharmacological treatment of obesity using .
The framework focuses on European Medicines Agency-approved medications such as orlistat, naltrexone/bupropion, liraglutide, semaglutide, and tirzepatide.
A comprehensive literature search is being conducted, including randomized controlled trials lasting at least 48 weeks.
Planned analyses will compare the effectiveness and safety profiles of treatments across various patient subgroups.
Guidelines target adults with a body mass index (BMI) ≥27 kg/m2 and at least one weight-related comorbidity or a BMI ≥30 kg/m2.
Primary and secondary outcomes include total body weight loss, changes in body composition, metabolic improvements, and quality of life.
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<p>Introduction: The aim of this study was to describe the design and methodological aspects of the upcoming European Association for the Study of Obesity (EASO) Framework for the Pharmacological Treatment of Obesity utilizing currently available evidence, which is grounded in a rigorous and transparent approach to evidence synthesis and guideline development. Methods: An expert panel of 13 members, selected by EASO, has developed the framework using the to ensure transparent, evidence-based guideline development. Clinical questions were formulated using the population, intervention, comparator, outcomes (PICO) framework, focusing on the effectiveness and safety of European Medicines Agency-approved obesity management medications, including orlistat, naltrexone/bupropion, liraglutide, semaglutide, and tirzepatide. A comprehensive literature search is being conducted using Medline and Embase, including randomized controlled trials with a minimum duration of 48 weeks. Meta-analyses and network meta-analyses are planned to compare treatment effectiveness and safety profiles across various patient subgroups. The guidelines will target adults with a body mass index (BMI) ≥27 kg/m2 and at least one weight-related comorbidity or a BMI ≥30 kg/m2. The primary endpoint will be total body weight loss. Secondary outcomes include changes in body composition (i.e., fat mass, fat-free mass), metabolic improvements (i.e., glucose levels, HbA1c, lipid profile), remission of obesity-related comorbidities (i.e., type 2 diabetes, obstructive sleep apnea syndrome, metabolic dysfunction-associated steatotic liver disease, cardiovascular disease, and knee osteoarthritis), and improvements in mental health and quality of life. The methodological framework ensures that recommendations are tailored, evidence-based, and applicable across clinical settings. Conclusions: The EASO framework provides a structured and individualized approach to optimize pharmacological treatment for obesity. Its methodological rigor, based on GRADE and PICO, enhances the reliability, reproducibility, and clinical relevance of the guidelines. By integrating clinical efficacy, safety outcomes, and patient-specific factors, this framework offers solid, actionable guidance to support healthcare professionals in delivering high-quality, personalized obesity care. </p>.
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Barbara McGowan has received speaker and/or advisory fees from Novo Nordisk, Eli Lilly, Astra Zeneca, Janssen, Pfizer, MSD and a research grant from Novo Nordisk. B.M. is a shareholder of Reset Health. Andreea Ciudin has received speaking fees from Astra Zeneca, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Sanofi, Menarini and research grants from Eli Lilly, Novo Nordisk and Menarini, member of the DMC of Boehringer Ingelheim. Jennifer L. Baker has received a consulting fee and is an advisory board member for Novo Nordisk A/S with fees paid to her institution. Luca Busetto has received payment of honoraria from Eli Lilly, Novo Nordisk, Boehringer Ingelheim, Pfizer, Bruno Farmaceutici, Regeneron, Rhythm Pharmaceuticals and Pronokal as speaker and/or member of advisory boards. Dror Dicker has received speaker and advisory board fees from Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Astra Zeneca, and research grants from Eli Lilly, Novo Nordisk, and Boehringer Ingelheim. Gema Frühbeck has received payment of honoraria from Eli Lilly, Novo Nordisk, Regeneron, and Astra Zeneca as speaker and/or member of advisory boards, and payment of honoraria as member of the OPEN Spain Initiative. Gijs H. Goossens has no relevant conflicts of interest to declare related to this article. Matteo Monami has received speaking fees from Astra Zeneca, Bristol Myers Squibb, Boehringer Ingelheim, Eli Lilly, Merck, Novo Nordisk, Sanofi, and Novartis and research grants from Bristol Myers Squibb. Benedetta Ragghianti and Euan Woodward have no conflicts of interest to declare. Paolo Sbraccia received payment of honoraria and consulting fees from Boehringer Ingelheim, Chiesi, Novo Nordisk, Eli Lilly, Pfizer, and Roche as a member of advisory boards. Borja Martinez-Tellez has received grants from the EASO New Clinical Investigator Award 2024 and the EFSD Rising Star 2024, both supported by the Novo Nordisk Foundation. Volkan Yumuk was engaged in advisory boards and lectures with: Novo Nordisk, Eli Lilly, Rhythm, and Regeneron. Volkan Yumuk, Gema Frühbeck, and Jennifer L. Baker were members of the journal’s Editorial Board at the time of submission.
