The European Association for the Study of Obesity (EASO) has introduced a new clinical management algorithm that reinforces a key message echoed across the medical community: obesity is a chronic, relapsing disease requiring long-term, sustained care.
Moving away from short-term, weight-focused approaches, the new EASO guidelines present a comprehensive, evidence-based framework centered on personalized, multi-faceted treatment strategies. The algorithm marks a major step forward in how obesity should be addressed across clinical settings — not as a temporary condition, but as a complex disease that demands continuous management, just like diabetes or hypertension.
A comprehensive, individualized approach
At the foundation of EASO’s new model lies a triad of core lifestyle interventions: nutrition, physical activity, and behavioral therapy. While these remain essential, the guidelines acknowledge that lifestyle changes alone are often insufficient for achieving and sustaining meaningful weight loss in many patients.
To close this gap, the algorithm integrates obesity management medications (OMMs) and, where clinically appropriate, metabolic bariatric surgery. The framework encourages healthcare providers to tailor interventions based on each patient’s specific health profile, comorbidities, and response to treatment.
Evidence-based pharmacologic recommendations
The EASO algorithm reviews a spectrum of approved OMMs, including orlistat, naltrexone/bupropion, liraglutide, semaglutide, and tirzepatide. Among these, The GLP-1 receptor agonists semaglutide and tirzepatide are identified as preferred first-line options when substantial weight reduction is required.
Key clinical highlights
Semaglutide is highlighted as a cornerstone therapy for a broad range of patients. It produces over 10% total body weight loss on average and offers proven benefits, including a reduction in all-cause mortality and Type 2 diabetes remission.
Tirzepatide, a dual GIP/GLP-1 receptor agonist, is recommended for patients with liver disease or obstructive sleep apnea, and as a co-first-line option for certain metabolic conditions.
Here are some condition-specific recommendations highlighted in Healthcare Radius:
Cardiovascular disease: Semaglutide was the only recommended OMM due to its proven ability to reduce Major Adverse Cardiovascular Events (MACE).
Heart failure: Both semaglutide and tirzepatide should be considered as first-line treatments.
Knee osteoarthritis: Semaglutide should be considered as the first-line treatment as it reduces pain associated with this condition.
Type 2 diabetes or prediabetes: Semaglutide and tirzepatide are first-choice medications, and liraglutide and naltrexone–bupropion are second-line treatments.
Perhaps the most significant takeaway from the EASO update is its emphasis on continuity of care. Clinical data show that discontinuing pharmacotherapy often results in weight regain, reinforcing the need for ongoing management.
This represents a crucial shift in mindset: Obesity treatment should mirror the long-term care models used for other chronic diseases, combining sustained pharmacologic therapy with lifestyle and behavioral support to improve health outcomes and quality of life.
New evidence: GLP-1 receptor agonists effective for pediatric obesity
While much of the EASO algorithm focuses on adults, emerging research highlights the growing importance of early intervention. A recent meta-analysis published in Pediatric Research by Romariz et al. found that GLP-1 receptor agonists — a class that includes liraglutide and semaglutide — are also effective in managing obesity in children.
Study findings
The meta-analysis included 11 randomized controlled trials with 1,024 participants aged 6-19. Results showed that GLP-1 agonists significantly reduced body weight, BMI, and waist circumference. Importantly, the study demonstrated clinically meaningful reductions in BMI even among children under 12 years old, a critical finding given the limited treatment options for younger patients.
Implications for pediatric care
The European Medicines Agency (EMA) recently recommended authorizing liraglutide for weight loss in children under 12, following a year-long trial in 82 participants showing significant BMI reductions.
The Romariz et al. study provides additional support for this move, confirming that GLP-1 receptor agonists are effective regardless of diabetes status or specific drug used. Early pharmacologic intervention may help improve long-term health outcomes and reduce future cardiovascular risk by addressing obesity before it progresses into adulthood.
A step toward population health improvement
By identifying effective pharmacologic tools for managing obesity across all age groups, these developments have the potential to transform public health. Treating obesity early, especially in children, can dramatically lower the lifetime burden of cardiovascular disease, diabetes, and other obesity-related conditions, ultimately reducing healthcare costs and improving overall quality of life.
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Source: “EASO releases new obesity care model focused on long-term results,” Healthcare Radius, 10/13/25
Source: “Semaglutide, Tirzepatide Named First-Line Drugs for Obesity,” Medscape, 10/9/25
Source: “Weighing up the options: childhood intervention to tackle obesity,” Nature.com, 10/9/25
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