A Narrative Review of Weight Management Strategies: From Lifestyle Interventions to Emerging Pharmacotherapies.

Abstract

Background: Obesity is a chronic, multifactorial disease associated with significant cardiometabolic, psychological, and socioeconomic consequences. Its complex etiology necessitates integrated, evidence-based management strategies beyond simple caloric restriction.

Objective: This narrative review aims to critically evaluate current and emerging weight management strategies, including lifestyle interventions, dietary patterns, behavioral approaches, pharmacotherapy, and bariatric procedures, with attention to efficacy, limitations, sustainability, and real-world applicability.

Methods: A structured literature search was conducted using PubMed, Scopus, ScienceDirect, and Google Scholar to identify relevant peer-reviewed articles on obesity management. Studies addressing dietary strategies, physical activity, behavioral therapy, antiobesity medications, and surgical or endoscopic interventions were included. Evidence was synthesized narratively, emphasizing comparative effectiveness, safety considerations, and long-term challenges.

Results: Lifestyle interventions remain the foundation of obesity management; however, long-term success is often limited by physiological adaptations, behavioral factors, and socioeconomic barriers. Among dietary approaches, differences in weight loss tend to diminish over time, highlighting adherence and sustainability as key determinants of success. Pharmacotherapy has advanced significantly, particularly with incretin-based agents such as GLP-1 receptor agonists and dual GIP/GLP-1 agonists, which produce substantial weight loss and cardiometabolic benefits but require ongoing use and may be limited by cost and tolerability. Bariatric surgery remains the most effective long-term intervention for severe obesity, while less invasive endoscopic procedures are expanding treatment options. Behavioral and psychological support plays a critical role in improving adherence across all interventions.

Conclusion: Effective obesity management requires a personalized, multidisciplinary approach integrating sustainable lifestyle strategies with pharmacological or procedural therapies when appropriate. While recent therapeutic innovations have expanded treatment possibilities, long-term success depends on behavioral support, accessibility, and continued evaluation of safety and cost-effectiveness.