Clinical Guidelines & Best Practices

This page provides up-to-date clinical guidance for the use of GLP-1 receptor agonists in the management of obesity, type 2 diabetes, and metabolic syndrome. It summarizes professional consensus statements, evidence-based recommendations, and algorithmic treatment pathways endorsed by major medical societies.

Key Recommendations

  • First-line for Obesity: The Obesity Society and AACE recommend GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) for adults with BMI ≥30, or ≥27 with weight-related comorbidities.
  • Cardiometabolic Priority: The ADA and EASD advise GLP-1s as preferred agents in type 2 diabetes patients with atherosclerotic cardiovascular disease (ASCVD) or high risk.
  • Lifestyle First, Then Adjunct: GLP-1 medications are recommended as adjuncts to intensive lifestyle interventions, not replacements.
  • Long-Term Use Validated: Sustained use (12–24 months) has been associated with better long-term weight maintenance and glycemic control.

Clinical Algorithm Example (Weight Loss Focus)

  1. Assess BMI, comorbidities, and weight loss history
  2. Initiate lifestyle intervention (diet, physical activity, behavior)
  3. Reassess at 3 months:
    • If < 5% weight loss, consider pharmacotherapy
    • Screen for GLP-1 therapy eligibility
  4. Start GLP-1 therapy with appropriate titration
  5. Continue monitoring for 6–12 months and assess maintenance plan

Professional Society Sources

  • American Diabetes Association (ADA) 2024 Standards of Care
  • American Association of Clinical Endocrinologists (AACE) Obesity Guidelines
  • European Association for the Study of Diabetes (EASD)
  • The Obesity Society (TOS) Practice Guidelines

Emerging Guidance

  • Use of dual and triple agonists (e.g., tirzepatide, retatrutide) under close specialist supervision
  • Integration with multidisciplinary care teams (nutrition, behavioral therapy, endocrinology)
  • Patient-centered titration based on tolerability and adherence

Printable Downloads

Coming soon: Downloadable guideline summaries, flowcharts, and shared decision-making tools.

Disclaimer

These guidelines are intended for licensed healthcare professionals. Always use in conjunction with your institution’s protocols and the latest updates from official medical organizations.