ACP Champions Multipronged Approach to Addressing Obesity

In a recently published position paper, ACP offers guidelines for improving access to obesity treatment

Sept. 4, 2026 (ACP) -- The American College of Physicians is calling for increased access to obesity treatment and affordable, nutritious foods, among other recommendations aimed at addressing the obesity epidemic.

These recommendations are outlined in a new position paper titled “Public Policy Approaches to Addressing Adult Obesity,” which is published in Annals of Internal Medicine.

The new policy recommendations are aimed at a broad range of stakeholders, including the health care sector, agriculture and nutrition leaders, researchers, policymakers and others involved in the prevention and treatment of obesity, explained Ryan Crowley, ACP manager for health policy.

Specifically, ACP recommends that health plans offer a comprehensive obesity benefit package that includes services to screen for and prevent obesity, intensive lifestyle treatment services, pharmacologic treatments and surgery.

“Since weight management medications are expensive and cost affects coverage and access, we call for policy interventions to lower the cost of drugs,” Crowley said. “We also discuss expanding access to affordable, nutritious foods and controlling processed foods that hurt health and ways to encourage physical activity, which affects overall health.”

ACP is advocating for evidence-based prescription food programs and sufficient reimbursement for physician-led, team-based care models to prevent, diagnose and manage obesity.

ACP also recommends developing a formal, evidence-based definition of, and appropriate restrictions on, ultraprocessed foods and supports efforts to educate the public about healthy eating through accurate food labels and educational resources based on evidence-based dietary guidelines that are not influenced by industry.

Community planning and policies that encourage safe, zero- and low-emission active transportation, such as pedestrian- and bicycle-friendly infrastructure, and safe physical activity are also important ways to address the obesity epidemic, especially in low-income and historically marginalized areas that have limited access to green space, according to ACP.

The paper authors also call attention to the stigma and bias associated with obesity and larger body types that are based on the misconception that weight is only a matter of self-control, willpower or whether an individual can stick to a diet.

“Obesity is more complex than that,” Crowley said. “A lot of people with obesity report they've experienced weight stigma or bias while interacting with clinicians, which discourages patients from seeking care.”

ACP also supports obesity research and sufficient funding and staffing for federal research agencies to better understand the origins behind obesity and best practices in obesity screening and treatment, Crowley said.

“With rates of obesity steadily rising, it is crucial for policymakers to help healthcare professionals by enacting systemwide changes that contribute to obesity, including behavioral, metabolic and environmental factors,” Dr. Jan K. Carney, ACP president, said in a statement.

The new position paper dovetails with a recent ACP living clinical guideline that helps physicians choose medications with lifestyle modifications to manage overweight and obesity in adults. The living guideline, titled “Pharmacologic Treatments With Lifestyle Modifications in Nonpregnant Adults With Overweight or Obesity in Outpatient Settings,” is published in Annals of Internal Medicine. (The “living guideline” designation means that there will be regular literature surveillance and clinical guideline recommendations will be updated if new evidence shows the need for a revision.)

For nonpregnant adults with obesity (body mass index ≥ 30 kg/m²), ACP suggests semaglutide and tirzepatide as first-line options when initiating pharmacologic treatment with lifestyle modifications for weight management (conditional recommendation; moderate-certainty evidence). ACP suggests phentermine-topiramate as a second-line treatment, liraglutide as a third-line treatment and naltrexone-bupropion as a fourth-line treatment (conditional recommendation; low-certainty evidence).

For nonpregnant adults with overweight (BMI ≥ 27 to 30 kg/m²) and type 2 diabetes, dyslipidemia, hypertension, obstructive sleep apnea, or cardiovascular disease, ACP suggests semaglutide or tirzepatide as a first-line treatment (conditional recommendation; moderate-certainty evidence) and liraglutide as a second-line treatment, with lifestyle modifications (conditional recommendation; low-certainty evidence).

Physicians and patients should discuss benefits, harms, costs, access and availability, comorbidities, weight-loss goals, life expectancy, values and preferences, and contraindications and warnings when considering a recommended weight-loss medication for adults with overweight and a weight-related comorbidity or obesity. Counseling patients about potential unintended side effects of weight loss, including nutritional deficiencies and loss of muscle and bone density, especially in older adults, is also important, the ACP living clinical guideline states.

More Information

The position paper “Public Policy Approaches to Addressing Adult Obesity” is available on the Annals of Internal Medicine website.

Back to the September 4, 2026 issue of ACP Advocate