From lifestyle and behavioural interventions to pharmacotherapy and bariatric surgery, there is significant variation in response to treatment among people living with obesity. Anti-obesity pharmacotherapies are becoming increasingly efficacious and are associated with good safety and tolerability. However, it is not yet possible to predict who will respond to which agent, presenting a challenge for treating physicians.

Currently, the only reliable indication of effective long-term weight loss with anti-obesity medication is early response, typically defined as ≥5% weight loss within 3 months of treatment initiation. Initial choice of anti-obesity medication is based on several factors including physician and patient preference, comorbidities, comedications, tolerability, average efficacy and cost. After 3 months, the decision to continue or switch the medication is made by the physician and patient based on efficacy and tolerability. While this trial-and-error method might be the best option based on current evidence, it leaves a lot to be desired when striving for optimal patient outcomes. So, is there an alternative approach that might offer improved responses earlier?



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