The European Association for the Study of Obesity has published a position statement whose argument is not about whether incretin drugs work. It treats that as settled. The argument is that everything around the prescription has failed to keep pace: patient selection, monitoring, clinician training and access have all moved more slowly than the drugs, and that gap decides whether the drugs deliver anything at population scale. EASO calls it the Integration Paradox and proposes five pillars for closing it. For anyone already on one of these drugs, the useful part is what the society says adequate care looks like.
The five pillars, and what each one asks for
Right Patient asks that eligibility turn on obesity severity, complications, clinical phenotype, treatment history and expected benefit rather than BMI alone, with different pathways across the life course instead of one uniform prescribing model. Right Care asks that pharmacotherapy be embedded in nutritional care, physical activity support, behavioural support and structured patient education rather than delivered as a standalone intervention. Right Workforce notes that formal training in obesity medicine remains thin across European undergraduate and postgraduate programmes while prescribing spreads into cardiology, nephrology, hepatology and primary care, and calls for a common competency framework. Right Data is the most concrete: monitoring should extend past body weight to waist circumference and waist-to-height ratio, cardiometabolic risk factors, treatment adherence, adverse events, recorded reasons for discontinuation, patient-reported outcomes, and body composition where it can be measured. Right Access asks for transparent reimbursement and prioritisation designed so that wider availability narrows inequality rather than widening it.
What travels, and what does not
The document is written for European health systems. Its reimbursement and workforce sections assume public payers and national training structures, and they do not map onto the US market in any direct way. What does travel is the Right Data list, which reads as a checklist for what care around one of these prescriptions ought to include. Something other than weight is measured. A reason is recorded when someone stops. The treatment is framed as management of a chronic condition rather than a course to be finished, which the statement grounds in the evidence that continued use maintains the loss while discontinuation is usually followed by regain. That is a fair yardstick to hold a telehealth provider to. A service that weighs you, refills a pen and measures nothing else is delivering less than the society writing this considers care.
Two limits are worth stating plainly. A position statement is expert consensus, not new evidence, and this one is a framework rather than a tested intervention: EASO names accountability metrics such as the proportion of eligible patients receiving treatment, but sets no thresholds or targets against them, and reports no pilot of the framework in practice. And the competing-interests declaration is substantial. Of the ten authors, five report consulting fees or honoraria from Novo Nordisk, Eli Lilly, or both, in some cases paid to their institutions and in one case directly; several also report ties to other manufacturers. Three declare no competing interests. That does not invalidate the framework, and the recommendations largely push toward more scrutiny of these drugs rather than less, but a document arguing for their wider and better-supported integration carries that context with it.
Sources: Correia JC, Baker JL, Boyland E, Busetto L, Fábryová L, Helgason T, Sbraccia P, Woodward E, Yumuk V, Pataky Z, for the European Association for the Study of Obesity. Integrating incretin-based therapies into comprehensive obesity care: an EASO position statement. The Lancet Regional Health – Europe, 3 September 2026;70:101840. doi:10.1016/j.lanepe.2026.101840.
