The popularity of GLP-1 therapeutics such as semaglutide (Ozempic, Wegovy, Rybelsus) and tirzepatide (Mounjaro, Zepbound) has dramatically changed the treatment of obesity. But experts say these drugs are just one piece of the puzzle in managing one of the most prevalent chronic diseases in the United States.
A new commentary has been published in the Journal of the American College of Gastroenterology Gastroenterology We revisit the influential POWER (Practical Guide to Obesity and Weight Management, Education, and Resources) framework, first introduced in 2017. Titled “Revisiting POWER in the GLP-1 Era,” this update reflects major developments in obesity care, from the advent of highly effective weight loss drugs to advances in endoscopic therapy, widespread use of bariatric surgery, and the growing role of precision medicine.
Obesity treatment is expanding beyond drug therapy
According to the authors, GLP-1 receptor agonists have revolutionized the treatment of obesity. At the same time, obesity treatment is becoming increasingly comprehensive, emphasizing the combination of pharmacotherapy with endoscopic procedures and surgical options when appropriate.
The updated framework also incorporates the new concept of clinical obesity. This approach recognizes obesity as a chronic disease that affects multiple systems in the body and highlights the limitations of relying solely on body mass index (BMI) to assess health risks.
Researchers note that obesity treatment is increasingly moving toward a multidisciplinary model that integrates different treatment approaches. Rather than viewing medications, procedures, and surgeries as separate strategies, experts view them as complementary tools that can be tailored to each individual patient.
New evidence supporting endoscopic treatment
This commentary highlights the growing evidence for endoscopic bariatric and metabolic treatments, including endoscopic sleeve gastroplasty, as effective treatment options for obesity.
The authors also note that advances in genetics and precision medicine could help doctors identify treatments that are most likely to benefit a particular patient. As researchers learn more about the biological factors that influence obesity, treatment plans are likely to become increasingly individualized.
Another promising area involves treatment combinations. There is evidence that combining GLP-1 drugs with endoscopic or bariatric surgery may result in greater weight loss and longer-lasting results than either approach alone.
The role of gastroenterologists in obesity treatment
The paper also highlights the important role gastroenterologists and hepatologists play in treating obesity and its related health complications.
These professionals frequently care for patients with conditions related to obesity, such as fatty liver disease associated with metabolic dysfunction (MASLD), gastroesophageal reflux disease (GERD), gallbladder disease, and various gastrointestinal complications associated with obesity. With this close involvement, the authors argue, gastroenterologists and hepatologists are well-positioned to guide the future of obesity management as treatment options continue to evolve.
