Published Nov 09, 2026 | 7:00 AM ⚊ Updated Nov 09, 2026 | 7:00 AM
Drugs such as Ozempic and Wegovy act like brakes on our appetite.
Synopsis: A position statement by the International Federation for the Surgery of Obesity and Metabolic Disorders says doctors should be allowed to prescribe obesity medications based on their training and competence, not speciality. It identifies India among countries with speciality-based restrictions and calls for trained bariatric surgeons and other physicians to be recognised as eligible prescribers under defined competency standards.
Doctors should be allowed to prescribe obesity management medications based on their training and competence, rather than their medical speciality, the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) has said in a new position statement.
The statement, published in The Lancet Diabetes and Endocrinology on 30 October, argues that restricting prescribing rights to specific specialities could delay treatment, limit geographical access and fragment care for people living with obesity.
“Eligibility to prescribe obesity management medications (OMMs), including GLP-1 receptor agonists and dual incretin agonists, should rest on demonstrated training and the capacity to deliver comprehensive obesity care, not on specialty title alone,” the authors said.
They added that the principle should apply across medical disciplines, including primary care, and that physicians who meet defined competency standards should be eligible to prescribe these medicines.
The position statement comes as India has intensified regulatory surveillance of the GLP-1 drug supply chain amid concerns about unauthorised sales and promotion.
On 24 March 2026, the Union Ministry of Health and Family Welfare said that GLP-1 drugs had been approved in India subject to prescription by endocrinologists and internal medicine specialists, and by cardiologists for certain indications. It warned that using these medicines without proper medical supervision could lead to serious adverse effects.
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The authors describe obesity as a “chronic, relapsing disease” that requires continuous medical assessment, lifestyle support, appropriate treatment selection and long-term follow-up. They argue that prescribing should form part of comprehensive care rather than remain the exclusive domain of doctors from selected specialities.
The position statement identifies India among countries where prescribing eligibility for obesity medications is linked to a doctor’s speciality.
According to the authors, GLP-1 receptor agonists in India are approved for prescription by endocrinologists and internal medicine specialists, and by cardiologists for certain indications. Japan and Malaysia also restrict insurance-covered or public-sector prescribing to specified specialities.
The authors contrast this with France, which opened obesity medication prescribing to all physicians in 2025 after specialist-only initiation reportedly led to long waiting periods and unequal geographical access.
Since June 2026, France has also included metabolic bariatric surgeons with an inter-university diploma in obesity surgery, practising in designated centres, among those eligible to initiate reimbursed treatment.
The IFSO authors argue that speciality-based restrictions can exclude doctors who already have the necessary experience to manage obesity.
“Many current rules tie prescribing rights to a specialty rather than to competence in managing the chronic disease of obesity,” they said.
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The statement proposes five areas of competence that physicians should demonstrate before prescribing obesity management medications.
These include understanding obesity as a disease, including its biological, nutritional, psychological and social determinants; knowledge of pharmacology, including drug mechanisms, dosage adjustments and contraindications; and the ability to select appropriate treatments based on individual patient needs.
Doctors should also be able to monitor patients over the long term, assess treatment response and adverse effects, and track nutritional status and muscle function. The fifth requirement is the ability to provide team-based, person-centred care involving dietitians, mental health professionals, exercise specialists and nurses.
The authors stress that obesity treatment cannot be reduced to prescribing medicines.
“Optimal treatment requires careful assessment, continuous lifestyle support, and selection among pharmacological, endoscopic, and surgical options, all with long-term follow-up,” they said.
Physicians should understand when to use lifestyle interventions, medications, endoscopic procedures or metabolic bariatric surgery, and when these approaches should be combined or sequenced. They should also counsel patients about possible weight regain and the recurrence of complications, including type 2 diabetes, after medication is discontinued.
A central recommendation is to allow trained metabolic bariatric surgeons to prescribe obesity medications as part of a patient’s treatment pathway.
The authors argue that excluding surgeons solely because of their speciality could disrupt continuity of care, particularly for patients who undergo surgery and later require medication.
IFSO’s earlier consensus recommendations support the use of obesity medications after metabolic bariatric surgery in patients with suboptimal clinical responses or recurrent weight gain. Medication may also be considered before revision surgery.
“Mandating a separate endocrinology referral solely to start or adjust an OMM might delay treatment and add cost when the surgeon is competent to prescribe,” the authors said.
They clarified that referrals should remain available when additional expertise is needed, but should not become mandatory when the treating physician already has the required competence.
The statement also notes that treatment decisions need coordination with anaesthesia teams when patients taking obesity medications undergo bariatric surgery. The authors point out that decisions on continuing or stopping medication around surgery require individual risk assessment and coordination between treating teams.
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To establish competence-based prescribing, IFSO recommends recognising obesity-specific training and certification across medical specialities.
The authors cite the American Board of Obesity Medicine (ABOM), which certifies physicians from different base specialities through continuing medical education or recognised fellowship programmes, followed by an examination.
They also refer to the World Obesity Federation’s SCOPE certification, which is open to health professionals, including surgeons, with at least six months of practical experience in obesity management.
“Obesity competence can be defined, taught, and examined across specialties,” the authors said, citing the ABOM certification framework.
The statement recommends recognising these certifications, obesity medicine fellowships and equivalent national or professional society training programmes. It also proposes a joint task force involving IFSO and the World Obesity Federation to develop a curriculum applicable across specialities.
The authors want healthcare systems to ensure access to multidisciplinary care, evidence-based lifestyle support and documented long-term follow-up for patients receiving these medications. They also call for services prescribing obesity drugs across specialities to monitor and report treatment safety, effectiveness and continuity of care.
(Edited by Dese Gowda)
