New framework guides safer obesity drug prescribing in older adults

Today, the American Geriatrics Society (AGS) released a new framework to assist clinicians to safely prescribe obesity medications in older adults. 

Organized around a series of cases, the framework offers a practical approach to prescribing obesity medications, including GLP-1 medications, that act through gut-derived hormonal pathways to older adults. While these medications offer promising benefits for weight management, glycemic control, and other health conditions, older adults are under-represented in clinical trials. The AGS framework emphasizes that clinicians should carefully consider age-related factors such as sarcopenia and frailty, risk of lean muscle loss, malnutrition, and dehydration.

This new paper, developed by the AGS Healthy Aging Special Interest Group, discusses key considerations for the use of obesity medications in older adults. The paper explores how to apply the Geriatrics 5Ms Framework (Mind, Mobility, Medications, Multicomplexity, and Matters Most) to incretin therapy in older adults. 

The authors emphasize that safe prescribing requires pretreatment assessment of functional status, nutritional adequacy, and cognitive impairment. They recommend that treatment be paired with key co-interventions such as resistance training and adequate dietary protein intake. They note that for some older adults, a team‐based approach, involving a registered dietitian, physical therapist, fitness trainer, and behavioral health professional may be most appropriate.