(Vienna, 14 July 2026) – An international team of 26 expert authors, with the involvement of MedUni Vienna, has published the first-ever joint recommendations on the management of incretin-based therapies for obesity. The consensus paper, published in The Lancet Diabetes & Endocrinology, emphasises the crucial importance of medical nutritional therapy, regular physical activity and psychological support for successful, long-term pharmacological treatment of obesity.
Modern incretin-based medicines, such as GLP-1 receptor agonists, have fundamentally transformed the treatment of obesity. However, the consensus paper by the European Association for the Study of Obesity (EASO), the European Federation of the Associations of Dietitians (EFAD) and the European Coalition for People Living with Obesity (ECPO) makes it clear that the long-term success of these drug therapies depends largely on comprehensive nutritional, functional and psychological support.
Nutritional therapy as a central component
One key focus of the consensus paper is on medical nutritional therapy. This should not only ensure an adequate intake of protein, vitamins and minerals, but also help to reduce gastrointestinal side effects of the medicines and establish healthy eating habits in the long term. The authors emphasise that nutritional therapy should be provided by qualified dietitians and form part of a multidisciplinary treatment plan.
Maintaining muscle mass and monitoring function
The consensus paper points out that incretin-based therapies can lead to a loss not only of fat mass but also of fat-free body mass, particularly muscle mass. The authors therefore recommend regularly monitoring body composition and physical function, and specifically integrating strength training into the treatment plan. In addition to BMI, waist circumference and simple functional tests, such as handgrip strength, should also be taken into account.
Taking mental health into account
Psychological aspects also play an important role. Although mental health often improves with drug therapy, existing psychological distress or eating disorders may persist or recur. The consensus paper therefore recommends appropriate screening before the start of treatment, as well as ongoing psychological support where necessary.
Improving care and strengthening research
Furthermore, the authors draw attention to existing gaps in care. In many places, people with obesity still do not have adequate access to multidisciplinary treatment programmes or qualified nutritional therapy. At the same time, there are significant gaps in research, for example regarding the long-term effects of the medicines on nutritional status, muscle and bone health, and quality of life. The consensus paper therefore sets out specific priorities for future research.
"These new medications open up new treatment options for many people with obesity. However, they can only fulfil their potential when embedded within a comprehensive, multidisciplinary care model. Nutrition therapy, physical activity and psychological support are not optional add-ons, they are essential components of high-quality obesity management," says Maria Wakolbinger from the Center for Public Health at MedUni Vienna, co-author of the consensus paper and head of the EASO Nutrition Working Group.
With this joint consensus paper, EASO, EFAD and ECPO are presenting, for the first time, Europe-wide coordinated recommendations that emphasise the importance of nutritional therapy as well as functional and psychological support measures in the pharmacological treatment of obesity. The aim is to further improve care for people with obesity and to support the safe, long-term use of these new therapies.
Publication: The Lancet Diabetes & Endocrinology
Dobbie LJ et al.: Nutritional, functional, and psychological considerations for incretin-based therapies in adults—an EASO, EFAD, and ECPO Consensus Statement. The Lancet Diabetes & Endocrinology, published online on 8 July 2026. DOI: 10.1016/S2213-8587(26)00122-1.
https://www.thelancet.com/journals/landia/article/PIIS2213-8587(26)00122-1/fulltext