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AGA answers: When to prescribe anti-obesity medications

Weigh in on AGA’s proposed quality indicators for the pharmacological management of obesity.
Three open bottles of prescription medication.
Three open bottles of prescription medication.

The AGA Quality Committee has developed quality indicators for the use of anti-obesity medications and seeks your input about these statements. Please complete our survey by Feb. 15.

What are quality indicators?

Quality indicators are statements derived from published guidelines and consensus documents that describe appropriate care related to a disease state, from diagnosis to management. Quality indicators provide a framework for providing evidence-based, guideline-supported care and can be used at an individual- or practice-level to measure high-quality care and reduce variations in care. Learn more.

Proposed quality indicators for pharmacological management of obesity:

  1. Anti-obesity medications should be considered in adult patients with BMI > 25 kg/m2 who have a concomitant diagnosis of a weight-related condition, lack clinically significant weight loss via lifestyle intervention alone over a 3-month period (defined by > 5% total body weight), and who do not have contraindication to medication use.
  2. Anti-obesity medications should be prescribed in the patient population referenced above who are interested in these medications by gastroenterologists who feel comfortable with these classes of medications or, alternatively, patients should be referred to weight management specialists who can provide access and monitor care.
  3. In patients with confirmed diagnosis of indeterminate and high risk metabolic-dysfunction associated steatohepatitis (MASH) and no contraindication to use, Semaglutide or similar GLP1RAs should be discussed as the first line anti-obesity medication.
  4. In patients who begin therapy with an anti-obesity medication, concomitant lifestyle counseling addressing dietary modifications and physical activity goals should be provided to augment effect and optimize medication safety and tolerance, and long-term monitoring to assess efficacy and need for alterations in care.
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