Obesity redefined: GLP-1 drugs lead a new era of treating obesity as a chronic cardiometabolic disease | Research

The takeaway

Obesity is being redefined as a chronic disease beyond BMI, with GLP-1 drugs like semaglutide and tirzepatide offering cardiovascular, renal, and liver benefits alongside weight loss, though only 25% of patients receive evidence-based treatment.

<25% receive treatment
Despite transformative GLP-1 drugs, less than one in four people with obesity receives evidence-based treatment—a critical access gap

What the researchers found

BMI inadequate for individual obesity assessment. GLP-1 drugs (semaglutide, tirzepatide) provide weight loss + cardiovascular, renal, liver benefits. <25% of obese individuals receive evidence-based treatment. Need for upstream, cardiometabolic-focused approach.

Why it matters

The gap between effective treatments (especially GLP-1 drugs) and actual treatment delivery is enormous. Reframing obesity as a chronic disease requiring proactive medical management could improve access to transformative therapies.

How the study worked

Narrative review of evolving obesity definitions, management strategies, and cardiometabolic prioritization.

What this study cannot tell us

Narrative review. US-centric healthcare perspective. Treatment access barriers (cost, insurance) not fully addressed.

How to read the evidence

Narrative review synthesizing current evidence and guidelines.

When this study was published

Published in 2025.

The bigger picture

GLP-1 drugs are accelerating a paradigm shift in how medicine approaches obesity—from lifestyle advice to evidence-based chronic disease management with measurable cardiometabolic outcomes.

Questions still open

How can the treatment gap be closed?
Should GLP-1 drugs be first-line for cardiometabolic obesity?
Will precision medicine enable personalized obesity treatment selection?

Common questions

Why is BMI not enough to measure obesity?

BMI simply divides weight by height squared—it cannot distinguish between muscle and fat, does not measure where fat is stored, and fails to predict individual metabolic risk. Two people with the same BMI can have very different health risks depending on their fat distribution and metabolic function.

Why are so few people getting obesity treatment?

Less than 25% of people with obesity receive evidence-based care due to stigma, lack of trained physicians, cost barriers, insurance coverage gaps, and the persistent misconception that obesity is simply a lifestyle choice rather than a chronic medical condition.

Read the original research

Obesity as a Chronic Disease: A Narrative Review of Evolving Definitions, Management Strategies, and Cardiometabolic Prioritization.

Advances in therapy, 42(11), 5341-5364

View on PubMed ↗Publisher’s paper ↗

Citation

Singh, Vidhi; Sun, Jia; Cheng, Susan; Kwan, Alan C; Velazquez, Amanda. (2025). Obesity as a Chronic Disease: A Narrative Review of Evolving Definitions, Management Strategies, and Cardiometabolic Prioritization.. Advances in therapy, 42(11), 5341-5364. https://doi.org/10.1007/s12325-025-03352-y