Europe's main obesity research society published a position statement on 3 September 2026 saying that medicines like semaglutide and tirzepatide have advanced faster than the health services meant to prescribe, monitor and pay for them.
The statement comes from the European Association for the Study of Obesity, known as EASO, and ran in the journal The Lancet Regional Health Europe. Ten authors signed it. It is an opinion document rather than a clinical guideline, and it reports no new trial results.
The authors give their argument a name: the EASO Integration Paradox. Their wording is that therapeutic innovation has advanced more rapidly than the health-system structures required for its optimal, equitable, and sustainable implementation. In plainer terms, the drugs arrived before the staffing, training, record keeping and funding needed to use them well.
Five headings the statement wants health systems judged against
The framework is built on five parts the authors call Right Patient, Right Care, Right Workforce, Right Data and Right Access.
Right Patient argues that who gets treated should turn on obesity severity, existing complications, clinical picture, treatment history, overall health and what the patient wants, rather than on body mass index alone. The authors also want separate pathways for children and teenagers, for people at reproductive life stages, and for older adults, instead of one prescribing model applied to everyone.
Right Care is the part with the most direct bearing on what happens in an appointment. The authors say these drugs should be delivered inside comprehensive obesity care rather than as stand-alone prescriptions, alongside nutrition support, physical activity, behavioural support, education about the treatment itself, and management of obesity-related conditions.
Right Workforce says formal obesity training is still thin across European medical education at undergraduate, postgraduate and continuing-education level. As heart, kidney, liver and family doctors start prescribing these medicines, the authors argue, they need skills that include managing side effects, shared decision making and reducing weight stigma.
Monitoring the authors say should go well beyond the scale
Under Right Data, the statement lists what it thinks should be tracked for a patient on these medicines: body weight, waist circumference, waist-to-height ratio, cardiometabolic risk factors, whether the patient is still taking the drug, side effects, reasons for stopping, outcomes the patient reports themselves, and body composition where a service can measure it.
The authors also name the safety questions they want European registries watching over the long term: stomach and bowel tolerability, gallbladder disease, changes in body composition, bone health, how these drugs are managed around surgery, exposure during pregnancy, and mental health outcomes.
Access gaps the authors say could widen rather than close
Right Access is the bluntest section. Reimbursement rules, eligibility criteria, waiting times, availability of specialist services and affordability all differ sharply between European countries. The authors argue that unless access is designed around fairness on purpose, expanding these treatments will widen health inequalities rather than narrow them. They call for people living with obesity to help write the rules that decide who is treated first.
They close with a caution aimed at their own field. The success of these medicines, they write, should not shrink obesity care down to prescribing, and prevention, patient education and stigma reduction still need investment.
Where the statement stops short, and who paid the authors
This is a position statement. It does not grade evidence, and it sets no dose, eligibility threshold or monitoring interval that a patient or a clinician could act on. It describes European health systems, so it says nothing about insurance coverage in the United States.
Five of the ten authors report honoraria or consulting payments from Novo Nordisk, Eli Lilly, or both, the companies that make the medicines the statement is about. Several of those authors report payments from other drug companies as well. Three authors declare no competing interests. The authors also disclose that they used ChatGPT to help with language editing and figure generation, while stating that the scientific content, interpretation and recommendations are their own.
Educational information only. This brief is not medical advice. Do not start, stop, or change treatment based on it.
Reporting note
OTN reviewed the linked sources and documents listed above. The article identifies estimates, projections, unresolved questions, and the limits of the evidence.
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