The weight is over as 2025 recommendations highlight proven drugs for sustained weight loss and health improvements
Study finds that obesity drugs are working — with long-term use delivering sustained weight loss and preventing the return of obesity-related complications.
The 2025 Canadian clinical practice guideline update on adult obesity management stresses that stopping medication often results in weight regain, even when health behaviour changes continue.
The update revises and expands on the 2020 Canadian guideline and the 2022 pharmacotherapy revision, incorporating six new and seven revised recommendations based on the latest evidence.
The guideline highlights that pharmacotherapy should be paired with health behaviour changes and tailored to each individual’s values, preferences, and specific health needs.
It supports long-term use of obesity medications to maintain weight loss and prevent the return of health risks.
The update applies to adults aged 18 years and older and is relevant to various clinical and benefits decision-making contexts.
Evidence from randomized controlled trials supports the effectiveness of semaglutide, tirzepatide, liraglutide, naltrexone–bupropion, orlistat, and setmelanotide.
Benefits include significant weight loss, improved glycemic control, reduced cardiovascular events, and targeted improvements for conditions such as heart failure, metabolic dysfunction–associated steatohepatitis, obstructive sleep apnea, and osteoarthritis.
Reported side effects range from mild gastrointestinal symptoms to less common gallbladder-related issues or pancreatitis.
Recommendations detail use for specific subpopulations, including those with atherosclerotic cardiovascular disease, heart failure with preserved ejection fraction, prediabetes, type 2 diabetes, obstructive sleep apnea, osteoarthritis, and certain rare monogenic causes of obesity.
The guideline advises against compounded or non-approved weight-loss medications due to concerns about safety, quality, and efficacy.
Obesity Canada emphasises the importance of reducing weight stigma, engaging in shared decision-making, and using measures of central adiposity alongside body mass index thresholds to guide treatment initiation.
The full guideline, hosted on the Obesity Canada website, includes clinical decision tools and resources to assist in aligning treatment approaches with the latest evidence.
