The Endocrine Society has issued a clinical practice guideline for the pharmacological management of obesity. The guideline recommends that diet, exercise, and behavioral modification be included in all obesity management approaches for BMI ≥ 25 kg/m², with pharmacotherapy and bariatric surgery used as adjuncts for BMI ≥ 27 kg/m² with comorbidities or BMI over 30 kg/m². Approved weight loss medications can be useful for patients who have not succeeded with diet and exercise alone. Medications commonly used for diabetes, depression, and other chronic diseases can affect weight, either promoting weight gain or loss. Prescribing medications with favorable weight profiles can help prevent and manage obesity. The guideline suggests using approved weight loss medications to ameliorate comorbidities and improve adherence to behavior changes, especially for individuals with BMI ≥ 30 kg/m² or those with BMI ≥ 27 kg/m² and at least one associated comorbid condition. It recommends against using sympathomimetic agents like phentermine and diethylpropion in patients with uncontrolled hypertension or a history of heart disease. Patients should be assessed for efficacy and safety at least monthly for the first 3 months, then every 3 months thereafter. If a medication is effective and safe, it should be continued; otherwise, it should be discontinued and alternative medications or treatment approaches considered. For patients with T2DM who are overweight or obese, the guideline suggests using antidiabetic medications that promote weight loss, such as GLP-1 analogs or SGLT-2 inhibitors, in addition to metformin. For patients with cardiovascular disease seeking weight loss treatment, medications that are not sympathomimetics, such as lorcaserin and/or orlistat, are recommended. The guideline also addresses drugs that cause weight gain and suggests alternatives, emphasizing the importance of considering weight effects when prescribing medications for conditions like diabetes, depression, and chronic diseases. The guideline emphasizes the importance of using weight loss medications as an adjunct to lifestyle changes and highlights the need for careful consideration of potential side effects and the importance of patient education. It also discusses the mechanisms of action of various pharmacological agents and the evidence supporting their use in the management of obesity. The guideline aims to provide healthcare providers with clear, evidence-based recommendations to help patients achieve and maintain weight loss, improve health outcomes, and reduce the risk of obesity-related comorbidities.The Endocrine Society has issued a clinical practice guideline for the pharmacological management of obesity. The guideline recommends that diet, exercise, and behavioral modification be included in all obesity management approaches for BMI ≥ 25 kg/m², with pharmacotherapy and bariatric surgery used as adjuncts for BMI ≥ 27 kg/m² with comorbidities or BMI over 30 kg/m². Approved weight loss medications can be useful for patients who have not succeeded with diet and exercise alone. Medications commonly used for diabetes, depression, and other chronic diseases can affect weight, either promoting weight gain or loss. Prescribing medications with favorable weight profiles can help prevent and manage obesity. The guideline suggests using approved weight loss medications to ameliorate comorbidities and improve adherence to behavior changes, especially for individuals with BMI ≥ 30 kg/m² or those with BMI ≥ 27 kg/m² and at least one associated comorbid condition. It recommends against using sympathomimetic agents like phentermine and diethylpropion in patients with uncontrolled hypertension or a history of heart disease. Patients should be assessed for efficacy and safety at least monthly for the first 3 months, then every 3 months thereafter. If a medication is effective and safe, it should be continued; otherwise, it should be discontinued and alternative medications or treatment approaches considered. For patients with T2DM who are overweight or obese, the guideline suggests using antidiabetic medications that promote weight loss, such as GLP-1 analogs or SGLT-2 inhibitors, in addition to metformin. For patients with cardiovascular disease seeking weight loss treatment, medications that are not sympathomimetics, such as lorcaserin and/or orlistat, are recommended. The guideline also addresses drugs that cause weight gain and suggests alternatives, emphasizing the importance of considering weight effects when prescribing medications for conditions like diabetes, depression, and chronic diseases. The guideline emphasizes the importance of using weight loss medications as an adjunct to lifestyle changes and highlights the need for careful consideration of potential side effects and the importance of patient education. It also discusses the mechanisms of action of various pharmacological agents and the evidence supporting their use in the management of obesity. The guideline aims to provide healthcare providers with clear, evidence-based recommendations to help patients achieve and maintain weight loss, improve health outcomes, and reduce the risk of obesity-related comorbidities.