Chronic relapsing disease. Titrate intensive lifestyle + GLP-1 / GIP-GLP-1 for BMI ≥ 30 (or ≥ 27 with comorbidity) to a ≥ 5% weight reduction at 16 wk; escalate to bariatric referral at BMI ≥ 40 or ≥ 35 + comorbidity when non-surgical therapy fails.
Authored pathway active · obesity-in-adults.outpatient
Chronic relapsing disease. Titrate intensive lifestyle + GLP-1 / GIP-GLP-1 for BMI ≥ 30 (or ≥ 27 with comorbidity) to a ≥ 5% weight reduction at 16 wk; escalate to bariatric referral at BMI ≥ 40 or ≥ 35 + comorbidity when non-surgical therapy fails.
Guidelines: AACE/ACE 2025 Obesity Framework · ADA 2026 Standards of Care — Obesity + Weight Management · AHA/ACC/TOS 2013 Obesity Guideline (still referenced for BMI thresholds)
Phenotypes (4)
- Class I Obesity (BMI 30–34.9) — Lifestyle-First Strategy
- Class II–III Obesity (BMI 35–39.9 or 40+) with Comorbidities — Pharmacotherapy
- Class III Obesity (BMI 40+ or 35+ with Comorbidities) — Bariatric Surgery Candidate
- Secondary Obesity — Endocrine Etiology (Hypothyroid / Cushing's / Monogenic)
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