Obesity care moves beyond GLP-1 drugs, specialists say
A Gastroenterology commentary says drugs such as Ozempic and Zepbound should be paired with procedures, surgery and more tailored care.
By Priya Raghavan · Science Reporter
3 min read
Specialists are calling for obesity treatment to move beyond reliance on GLP-1 medicines alone, even as drugs such as Ozempic and Zepbound have changed care for many patients. The American Gastroenterological Association said a new commentary in its journal Gastroenterology argues that better long-term results may come from combining medication with procedures, surgery and more individualized treatment plans.
The commentary, “Revisiting POWER in the GLP-1 Age,” updates the association’s POWER framework, short for Practice Guide on Obesity and Weight Management, Education, and Resources. The framework was first introduced in 2017, according to the association.
The update reflects the rapid spread of GLP-1 receptor agonists, including semaglutide, sold as Ozempic, Wegovy and Rybelsus, and tirzepatide, sold as Mounjaro and Zepbound. The American Gastroenterological Association said those medicines have significantly changed treatment for obesity, which it described as one of the most common chronic health conditions in the United States.
A broader treatment model
The authors argue that GLP-1 drugs should be viewed as one tool among several. According to the association, obesity care is increasingly bringing together medications, endoscopic bariatric and metabolic therapies, and bariatric surgery when those options fit a patient’s needs.
The commentary also incorporates the concept of clinical obesity. The American Gastroenterological Association said that approach treats obesity as a chronic disease affecting multiple body systems and points to the limits of using body mass index alone to judge health risk.
Endoscopic therapies are a central part of the updated discussion. The association said the commentary highlights growing evidence for procedures such as endoscopic sleeve gastroplasty as treatment options for obesity.
The authors also point to genetics and precision medicine as areas that could shape treatment selection. According to the association, advances in understanding biological drivers of obesity may help physicians identify which patients are most likely to benefit from a particular medication, procedure or operation.
Combining therapies
The commentary says combined treatment may be especially promising. The American Gastroenterological Association said evidence suggests pairing GLP-1 medicines with endoscopic procedures or bariatric surgery could produce more weight loss and more durable results than using one approach by itself.
The paper was written by Andres Acosta, Naresh Gunaratnam, Violeta Popov, Pooja Singhal, Janese Laster-Butler, Joel V. Brill, Rohit Kohli and John Magaña Morton. It was published in Gastroenterology in 2026, with the DOI 10.1053/j.gastro.2026.04.016.
The authors also emphasize the role of gastroenterologists and hepatologists in obesity care. The association said those specialists often treat obesity-related conditions, including metabolic dysfunction-associated steatotic liver disease, gastroesophageal reflux disease, gallbladder disease and other gastrointestinal complications.
Because those clinicians already see many patients with obesity-linked disease, the commentary argues they are well placed to help guide treatment choices as options expand. The American Gastroenterological Association said the updated POWER framework is meant to reflect that shift toward more coordinated and tailored care.
This story draws on original reporting from ScienceDaily.