Authors of a recent study examined whether primary care pediatricians’ documentation of overweight or obesity is linked to better obesity-related care in children and adolescents. Using data from the largest health maintenance organization in Israel, researchers identified patients aged 2 to 18 years with body mass index (BMI) recorded between 2017 and 2023. Among those with BMI percentiles in the overweight/obesity range, they compared care delivered to children who had a formal diagnosis of “overweight” or “obesity” recorded by their primary care pediatrician versus those with similar BMI percentiles but no recorded diagnosis.

Children with a documented diagnosis of overweight/obesity were more likely to receive comprehensive obesity-related care. They had higher rates of referrals for screening tests for obesity-related comorbidities, more dietitian and endocrine counseling, more frequent follow-up BMI measurements, and higher rates of anti-obesity medication prescriptions (all p<0.001). Obesity-related comorbidities were also more common in this diagnosed group. The authors conclude that beyond simply measuring BMI, formally recording a diagnosis of overweight or obesity is associated with more active management and intervention. They argue that primary care pediatricians should increase diagnosis recording and treat obesity as a chronic disease to support better screening and outcomes.

Reference: Shalitin S, Phillip M, Yackobovitch-Gavan M. Recorded diagnosis of overweight/obesity in primary care is linked to obesity care performance rates. Pediatr Res. 2025 Apr;97(5):1554-1565. doi: 10.1038/s41390-024-03619-0.

Obesity is linked to diabetes, cardiovascular disease, arthritis, some cancers, and at least $174 billion in excess health care spending annually, with costs peaking in people’s 60s. New antiobesity drugs have been found to achieve 15% to 20% weight loss in trials—far more than older medications—but they are expensive, may require lifelong use, and are not currently covered by Medicare Part D for weight loss. If Medicare were required to cover these medications, projected spending could range from under 1% to well over the entire Medicare Part D budget, even before accounting for use in patients who are overweight or those already using these drugs for diabetes.

Health technology assessors have raised concerns about cost-effectiveness: semaglutide was estimated at $237,000 per quality-adjusted life-year gained—well above common US thresholds—even though cheaper generic options such as phentermine–topiramate are available. Uncertainty is even greater for older adults, who are often underrepresented in trials, may gain less long-term benefit, and may be more vulnerable to harms such as loss of lean mass and gastrointestinal side effects. Given the high costs, unclear long-term outcome data, and potential impact on premiums and overall system spending, the authors argue that Congress and Centers for Medicare and Medicaid Services should move cautiously, basing any expansion of Medicare coverage on robust evidence and focusing access on those most likely to benefit.

Reference: Baig K, Dusetzina SB, Kim DD, Leech AA. Medicare Part D Coverage of Antiobesity Medications - Challenges and Uncertainty Ahead. N Engl J Med. 2023 Mar 16;388(11):961-963. doi: 10.1056/NEJMp2300516.

Authors of this systematic review synthesized recent evidence on adult obesity prevention and management across pharmacologic, surgical, dietary, exercise, and adjunctive therapies. Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, the authors searched major databases (2015–2025) and narrowed 4,749 records to 12 interventional studies. These included mostly randomized controlled trials of GLP-1 receptor agonists, bariatric and endoscopic procedures, structured exercise programs, time-restricted eating, probiotics, and comprehensive lifestyle interventions.

Across studies, GLP-1 agents consistently produced clinically meaningful, sustained weight loss and cardiometabolic improvement. Bariatric surgery and endoscopic sleeve gastroplasty achieved the greatest and most durable weight loss and diabetes benefits, with attendant surgical and nutritional risks. Exercise interventions—especially combined aerobic and resistance programs—reduced ectopic fat, improved insulin sensitivity, and enhanced functional capacity, and time-restricted eating and probiotics offered modest additional benefits, particularly when paired with exercise. Overall, the review supports a multimodal, individualized approach to obesity management. Thoughtfully combining diet, exercise, pharmacotherapy, and, when appropriate, metabolic or bariatric procedures yields the most robust and sustained improvements in weight and metabolic health.

Reference: Shankar G, Sharma J, Soni R, Gondalia S, Kumar V. Recent Trends in the Prevention and Management of Obesity Among Adults: A Systematic Review. Cureus. 2025 Aug 1;17(8):e89207. doi: 10.7759/cureus.89207.