The Endocrine Society published a Scientific Statement that synthesizes current evidence on obesity, emphasizes its complexity as a chronic disease, and sets a research agenda to address gaps exposed by the rapid introduction of new pharmacotherapies. The Statement summarizes what is known, what remains uncertain, and the research priorities needed to improve diagnosis, treatment, and long-term outcomes for people living with obesity.
The Statement stresses that obesity results from the interaction of multiple factors including biology, genetics, metabolic processes, brain regulation, and environmental influences. It rejects the notion that obesity is solely a matter of willpower, framing the condition as a chronic disease that often requires ongoing management. This conceptualization underpins the Statement’s call for long-term treatment strategies and research into disease mechanisms.
The authors note that obesity affects more than 40% of American adults and carries substantial economic burden. The Statement cites U.S. estimates of more than $173 billion per year in obesity-related medical costs. Clinically, untreated obesity contributes to poorer metabolic and mental health and impairs physical function, increasing risk for multiple comorbid conditions.
The Statement highlights that GLP-1–based therapies, including semaglutide and tirzepatide, have markedly changed the treatment landscape for overweight and obesity. These medicines not only promote weight loss but are being used to improve comorbidities such as cardiovascular disease, sleep apnea, and kidney and liver disease. The Statement also notes ongoing investigations into potential roles for these agents in conditions beyond cardiometabolic disease, including cancer, substance use disorders, arthritis, and infertility.
Although the new medications have shown efficacy, the Statement emphasizes important safety considerations. These include direct effects of the medications themselves, clinical consequences of relatively rapid weight loss, and uncertainties about long-term risks and outcomes. The authors argue that obesity is a chronic condition that often requires continued therapy: many people who discontinue treatment after reaching goal weight regain weight and experience worsening of blood pressure, cholesterol, and glycemic control. Conversely, studies report that some patients can preserve much of their weight loss when transitioned to lower-dose therapies or different medications, but the Statement calls for more evidence to guide such transitions.
The Scientific Statement identifies six priority areas that should guide future research:
Advancing research across these domains is framed as essential to refine disease biology, improve treatment precision, define meaningful clinical endpoints, and optimize use of emerging therapies.
The Statement calls for larger, longer, and more diverse clinical studies to address the priority questions. The authors emphasize the value of incorporating real-world data to better understand treatment outcomes across varied populations and clinical settings. Priority areas for methodological improvement include longer follow-up to assess durability and safety, enrollment of more diverse populations to improve generalizability, and endpoints that move beyond weight to capture functional status and disease-specific outcomes.
The Statement, titled "Obesity Science, Research Gaps, and Opportunities in the New Era of Obesity Medicines – an Endocrine Society Scientific Statement," was published online in Endocrine Reviews. It was developed by a Task Force appointed by the Endocrine Society and underwent internal and external review before a member comment period. Lead author Daniel J. Drucker, MD, summarized the document’s intent: “The rapid adoption of highly effective obesity medications has changed the treatment landscape, but important questions remain about their long-term use, individualized treatment strategies, side effects and the best ways to measure treatment outcomes.”
Other contributors named in the Statement include Ania M. Jastreboff, Harlan M. Krumholz, Michelle Van Name, Jamy D. Ard, Kevin D. Hall, Lee M. Kaplan, and Donna H. Ryan. The Scientific Statement is part of the Endocrine Society’s Center on Obesity initiative, which aims to advance obesity research and care.