New Recommendations for Weight Loss Drugs

By Patrick Wingrove

March 31, 2023

(Reuters) – Novo Nordisk’s Wegovy won U.S. approval in June 2021 with a label that says it can be used for chronic weight management in patients with a body mass index (BMI) of 27 or more who have at least one weight-related ailment, or in any patient with a BMI of 30 or greater.

Several leading international medical groups have since updated their recommendations on treating obesity while others are planning new guidance. Here are some of the new guidelines:

• Obesity Canada: Updated its standards of care document in October 2022 to include use of semaglutide, the chemical name for Wegovy, and a related diabetes drug. These guidelines say doctors should tailor treatments to individuals using nutrition, physical activity, psychological interventions, medications, and surgery, and that BMI is not an accurate tool to identify obesity-related ailments. They also say drugs can be used to maintain weight loss that has been achieved by behavioral changes.
• In November 2022, the American Gastroenterological Association (AGA) prioritized semaglutide over older medications in its new guidance but suggested that drugs should be used alongside diet and exercise changes in patients who had inadequate responses to lifestyle interventions alone. It also said patients would need to be on these drugs for life.
• The American Academy of Pediatrics (AAP): Published guidance in January recommending use of drugs in children ages 12 years or older in addition to lifestyle and behavior changes for obesity treatment, drawing criticism over the lack of long-term data for how weight loss drugs affect children and teens.
• The UK’s national healthcare governance body NICE: Earlier this month published guidance that says Wegovy should be reserved for patients with at least one weight-related health risk and a BMI of 35 or more, or, exceptionally, a BMI of between 30 and 35 and a referral to specialist weight management care. It also said Wegovy could only be used as a treatment for two years – the length of time it was tested in pivotal clinical trials.