ENDO 2026 in Chicago highlighted the resilience and breadth of contemporary endocrinology, with several sessions focused on weight, metabolism and the evolving role of incretin-based therapies. In a public Q&A on the expo floor, Daniel Drucker and Barbara Kahn discussed the current and future landscape of weight-loss treatments and the environmental drivers of rising population BMI.
Speakers acknowledged the striking clinical impact of GLP-1 medications, which were introduced for diabetes management and have since received approval for obesity treatment. Both Drucker and Kahn emphasized that these drugs are highly effective for many patients but are not a standalone solution. Kahn reminded attendees that behavioral measures and environmental change remain fundamental and noted the irony that the expo floor did not promote simple physical-activity tools such as stationary bikes.
Drucker and Kahn also discussed the longer-term view for obesity care. Drucker proposed two possible futures by 2036: one in which environmental and systemic changes reverse the population-level BMI increase, making widespread pharmacotherapy unnecessary; and another in which dozens of GLP-1–class drugs are available and affordable. Kahn and Drucker agreed that identifying and altering food manufacturing, processed-food composition and other environmental contributors should be a research priority to favor prevention over treatment.
Access and affordability were recurring themes at ENDO 2026. Although GLP-1 medications have been transformational for many patients with obesity, speakers underscored that not all patients can obtain or afford them. Daniel Drucker noted that in Canada a month’s supply of semaglutide costs about $78 Canadian, and he observed that some countries are beginning to see generic versions. However, cost remains a significant obstacle in many settings.
A session titled “Breaking Barriers: Addressing Endocrine Disorders in Underserved Populations” examined disparities in access to obesity treatments. Alicia Diaz‑Thomas cited historical context and persistent inequities, and Eric Bomberg highlighted that non-Hispanic White Americans have more access to bariatric surgery—particularly when private insurance is involved—while Black and Hispanic patients encounter more hurdles. The presenters noted that Asian, Black and Hispanic patients are less likely to use newer obesity medications, and education differences account for part of that gap.
Speakers argued that recognizing obesity as a disease and confronting biases about weight are necessary steps to improve access. Bomberg emphasized that the existence of effective medications is meaningless if systemic barriers prevent patients from receiving them.
ENDO presenters also showcased several recent research findings beyond GLP-1 headlines. A collaborative study involving about 80,000 adults using tirzepatide reported sex differences and comorbidity-related variability in weight loss: women tended to lose more weight than men, while preexisting conditions such as type 2 diabetes, high cholesterol, hypertension, metabolic liver disease and obstructive sleep apnea were associated with lesser weight loss. These results point to the importance of individualized treatment planning.
Other studies presented at the meeting expanded understanding of metabolic risk. Chinese investigators reported that among people with type 2 diabetes, daily naps longer than 30 minutes were associated with increased risk of metabolic dysfunction-associated steatotic liver disease, prompting the public-health recommendation to “nap wisely.”
In the menopausal-health arena, an industry-sponsored study of the FDA-approved nonhormone treatment fezolinetant found that the drug improved hot flashes as well as measures of depression and anxiety in women. Investigators noted that reproducing clinical-trial–like benefits in a broader real-world–type cohort is important because trial populations often have restrictive enrollment criteria and are healthier than general clinical populations.
The tone at ENDO 2026 was one of cautious optimism: endocrinology continues to evolve with new therapeutics and emerging evidence, but persistent challenges remain. GLP-1–based therapies have shifted care for many patients with obesity and related disorders, yet speakers repeatedly emphasized the need to pair pharmacologic advances with prevention, environmental change and improved access.
Presenters urged the field to continue investigating the roots of the obesity epidemic—food systems, processing methods, environmental chemicals and other societal factors—and to pursue research that bridges bench, clinical care and public health. They also highlighted health-equity work to ensure that innovations such as semaglutide, tirzepatide and related agents reach diverse populations without imposing catastrophic financial burdens.
ENDO 2026 served as a reminder that clinical advances, policy and systems-level work must proceed in parallel: while therapeutics can change the course of disease for individuals, sustainable population-level impact will require understanding and addressing upstream drivers. The meeting framed a future in which endocrinology continues to adapt, applying new notes to the discipline while seeking the preventive strategies that could obviate the need for widespread pharmacologic interventions.