Garvey WT, et al. - The observations indicate that it is now possible to manage Adiposity-Based Chronic Disease (ABCD) in a manner similar to other chronic diseases (including type 2 diabetes, hypertension, and atherosclerosis) which are treated to biomarker targets that can be altered depending on the clinical status of individual patients (i.e., HbA1c, blood pressure, and LDL-c) to avert the respective complications of these conditions.

• Prevention and treatment of complications associated with obesity, in order to improve health and mitigate morbidity and mortality, is the essential goal of weight loss therapy.

• Many complications need 10-20% weight loss to accomplish therapeutic targets but available obesity medications fail to confer ≥10% weight loss in most of the cases.

• Semaglutide 2.4 mg/week received approval in June, 2021, and conferred >10% placebo-subtracted weight loss, more than half of patients lost ≥15%, and over one third lost ≥20% of baseline weight, as evident in phase 3 clinical trials.

• Notably, this doubles effectiveness over existing options, offers sufficient weight loss to relieve a wide range of complications, and qualifies as the first member of a second-generation class of obesity medications.

• The emergence of second-generation medications completely allows a treat-to-target strategy for management of ABCD as a chronic disease.

• Especially, with such extent of efficacy, second-generation medications allow active management of body weight as a biomarker to targets linked with effective therapy and prophylaxis of specific complications.