American College of Physicians names semaglutide and tirzepatide first-line obesity drugs

The American College of Physicians issued a living clinical guideline on medicines for adults with overweight or obesity, published in Annals of Internal Medicine. For adults with obesity it ranks semaglutide and tirzepatide first-line (moderate-certainty evidence), phentermine-topiramate second, liraglutide third and naltrexone-bupropion fourth, all alongside lifestyle changes and all as conditional recommendations. It also advises counselling patients about unintended effects of weight loss, including nutritional deficiencies and loss of muscle and bone density, especially in older adults.