Link to EAHP Statements
Section 4 – Clinical Pharmacy: Statements – 4.1, 4.6, 4.8
Abstract
Obesity is now recognised as a chronic, relapsing disease that requires long-term management strategies focused not solely on weight reduction, but on improving health outcomes by preventing or reducing obesity-related complications. Achieving clinically meaningful weight loss, typically ≥10%, is essential to improving these complications. However, until recently, most anti-obesity medications failed to reach this threshold.
Semaglutide, a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist, reduces appetite and alters food-related behaviour through pathways in the central nervous system. Clinical trials have shown that over half of patients treated with semaglutide lost ≥15% of their baseline weight, and over one-third lost ≥20%, establishing it as the first in a second-generation class of anti-obesity agents. More recently, tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist, has demonstrated mean weight reductions of up to 22.9% over 3.5 years. This dual agonism is thought to enhance appetite regulation and act directly on fat cells via GIP receptor activity.
These advances in pharmacotherapy enable a treat-to-target approach for managing obesity, similar to strategies used in chronic conditions like diabetes or hypertension, where treatment is guided by individualised biomarker targets. The emergence of these highly effective agents may transform the treatment landscape for people living with obesity, allowing for the setting of clear, personalised weight loss goals and the adjustment of therapy to help patients reach these targets in a sustainable and effective way.
In this interactive session, the essential role of the Hospital Pharmacist (HP) in optimising pharmacotherapy, educating patients and healthcare teams, and ensuring safe and effective use of these emerging therapies is discussed.
Learning objectives
After the session, the participant should be able to:
– Compare the mechanisms of action, clinical efficacy, and safety profiles of semaglutide and tirzepatide in the treatment of obesity.
– Discuss the role of dual GIP/GLP-1 receptor agonism in weight regulation and its potential advantages over GLP-1 receptor monoagonism.
– Apply a treat-to-target framework in obesity pharmacotherapy, aligning weight loss goals with the prevention and treatment of obesity-related comorbidities.
Educational need addressed
This interactive session enhances the HP’s ability to contribute to multidisciplinary obesity management using a treat-to-target approach.
Keywords
GLP-1, GIP, obesity, type 2 diabetes, cardiovascular disease, weight loss.