Overview

• The Canadian Medical Association Journal published six new and seven revised recommendations in Obesity Canada’s 2025 adult pharmacotherapy guideline on August 11, reflecting evidence through May 2025.
• The update incorporates two newly approved medications, tirzepatide (Zepbound) and setmelanotide (Imcivree), and adds guidance on treating obesity-related complications such as cardiovascular disease, heart failure and osteoarthritis.
• Prescribing criteria move beyond body mass index to individualized assessments of central adiposity measures and obesity-related health conditions to guide medication use.
• Pharmacotherapy is endorsed as one of three long-term pillars of obesity care alongside behavioral and surgical interventions, and the panel advises against using compounded obesity medications over approved products.
• The guideline highlights persistent barriers to access—high out-of-pocket costs, uneven drug coverage and stigma—and notes that multiple author industry ties may affect implementation and generalizability.