Obesity care is changing as research provides doctors with more options for assessment and treatment. The U.S. Department of Veterans Affairs and Department of Defense (VA/DoD) updated its obesity management guideline in 2025, calling for care that looks beyond body mass index (BMI) and considers each patient’s health risks, preferences, and treatment needs.
The updated guideline recommends routine obesity screening with BMI, waist circumference, and the patient’s overall clinical context. This approach can give primary care physicians a clearer view of health risks than BMI alone.
The VA/DoD Evidence-Based Practice Work Group brought together a multidisciplinary panel to review research published from April 1, 2019, through January 6, 2025. The panel assessed treatment benefits, potential risks, patient preferences, and practical factors that can affect care.
More Treatment Options
Comprehensive lifestyle intervention remains the foundation of obesity management. However, the guideline supports adding treatment when lifestyle changes alone do not provide enough benefit.
Doctors can consider medications, including GLP-1 therapies, along with endoscopic procedures and bariatric surgery when appropriate. Treatment decisions should reflect the patient’s health status and preferences rather than follow a single fixed pathway.
The guideline describes obesity as a chronic disease that requires ongoing management. Flexible treatment plans can help patients access suitable therapies while supporting lasting health benefits.
The 2025 VA/DoD guideline shifts obesity care toward a broader, individualized approach. By combining lifestyle support with medication and procedural options when needed, primary care teams can address obesity based on health risks, patient needs, and long-term outcomes.
