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PubMed1 Apr 2026Obesity science & practice● 5/10i

Obesity Treatment Pathways and Implementation in Health Systems.

Chao AM, Walsh S, Rama PR, Samuels JM

A narrative review found little publicly available guidance on implementing obesity treatment pathways within health systems, identifying gaps in translating clinical guidelines into operational care processes. Narrative review examining screening, diagnosis, treatment, and monitoring elements across primary and specialty care settings. This highlights a critical implementation barrier as health systems struggle to operationalize obesity care despite established clinical guidelines and expanding treatment options. The review provides practical frameworks for pathway development but underscores the absence of standardized implementation resources.

Strategic Signal

Health systems lack structured pathways to operationalize obesity care despite guideline availability, creating barriers to treatment access that could limit uptake of new obesity medications like Wegovy and Zepbound. US health systems particularly struggle with care coordination between primary care and specialty providers, potentially fragmenting patient journeys from screening to advanced therapies. This implementation gap may favor integrated health systems with established obesity programs over fragmented fee-for-service models, influencing market access strategies for obesity drug launches.

Weight lossPricing/access

Original Abstract

BACKGROUND: Although clinical practice guidelines are valuable for managing obesity and should be the foundation for health system protocols for screening, diagnosis, and treatment, these guidelines need to be translated and implemented within clinical care pathways that account for organizations' processes, structures, and cultures. Variation in resources across systems is another challenge. METHODS: A narrative review was undertaken to assess how obesity treatment pathways can support health systems and HCPs in informed decision-making for obesity management, and to offer practical considerations for developing and implementing health care system treatment pathways. FINDINGS: Little publicly available information exists on developing and implementing obesity treatment pathways in clinical practice within health systems. This review discusses the key elements of obesity care, including screening, diagnosis, treatment, and monitoring, and outlines the roles and responsibilities of health care professionals within each step of the pathway. CONCLUSION: This review offers resources and considerations for developing and implementing obesity care pathways in primary care, specialty care, and various other settings to assist health systems and health care professionals in making informed, evidence-based decisions in obesity management.

Related signals

Strategic Signal

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GLP-1Type 2 diabetesPricing/accessEli LillyNovo Nordisk

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Clinical Trial19 Mar 2026Phase 3High impact● 9/10i

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Weight lossGLP-1Eli Lilly

Strategic Signal

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Weight lossOtherRhythm

Strategic Signal

Clinical Trial17 Apr 2026Phase 3High impact● 8/10i

A Phase 3, Open-Label Study of Once Daily LY3502970 Compared With Insulin Glargine in Adult Participants With Type 2 Diabetes and Obesity or Overweight at Increased Cardiovascular Risk

Phase 3 open-label trial compared once-daily oral orforglipron versus insulin glargine in people with type 2 diabetes and obesity or overweight at increased cardiovascular risk. The study enrolled 2,749 participants with primary endpoint of time to first major adverse cardiovascular event, completed in March 2026. Eli Lilly is positioning orforglipron as a cardiovascular outcomes option in high-risk populations, directly competing with established insulin therapy in this indication. This represents the first cardiovascular outcomes trial for orforglipron following its April 2026 FDA approval for type 2 diabetes.

GLP-1Type 2 diabetesWeight lossCardiovascularEli Lilly

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