GLP-1 Medications Need a Permanent Place in Primary Care, Says Obesity Medicine Specialist

August 7, 2025

Jonathan Bonnet, MD, MPH, encourages primary care clinicians to embrace GLP-1 therapy where appropriate to stem multiple risk factors for downstream chronic diseases.

I would argue that obesity is quite figuratively and literally, probably the biggest healthcare challenge we face, because all of the comorbidities that come with obesity are all the chronic conditions that you see in your clinic all day, every day.

Medications like Wegovy and Ozempic are household words in the US as the glucagon-like peptide-1 receptor agonists (GLP-1s) continue to help individuals with overweight and obesity significantly reduce body weight and improve cardiometabolic risk factors. As prescribing in real-world settings has widened, however, new challenges are emerging that extend far beyond appetite suppression, including nutritional deficiencies and loss of lean mass along with body fat.

To help clinicians navigate these complexities, 4 leading medical organizations, the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society, recently published a comprehensive joint advisory. This new guidance offers practical, multidisciplinary recommendations on managing nutritional balance, addressing gastrointestinal side effects, preventing muscle loss, and integrating lifestyle support.

Advisory coauthor and obesity medicine specialist Jonathan Bonnet, MD, MPH, recently spoke with Patient Care© about putting principles of the advisory into daily practice in primary care. The recommendations are wide-ranging but as Bonnet points out, not everything has to be accomplished at once and some elements of the recommendations may be more appropriate for some patients than for others. What he is emphatic about though, is the epidemic level of obesity in the US, the significant downstream health effects of the disease, and the essential role of primary care clinicians in managing obesity along side the range of other chronic conditions they see.

The following transcript has been lightly edited for style and flow.

Patient Care: How do you recommend that primary care clinicians approach the recommendations in the advisory—it’s a broad, broad palette of of options.

Jonathan Bonnet, MD, MPH: You don't have to do everything all at once. In healthcare, we have the luxury of working as a team. We have dietitians, behavioral psychologists, physical therapists, health coaches—a whole range of professionals who can help address what is a complicated, complex, long-term medical issue. So, first, rely on your team for aspects of care that are essential but may not be feasible for a physician to deliver alone.

GLP-1s are going to be here to stay. Whether you like them, believe in them, or not, they're set to become the biggest selling drugs of all time. They’re going to replace statins, barring something very unusual. Lots of patients will be on them. I would argue that obesity is—figuratively and literally—probably the biggest healthcare challenge we face, because all the comorbidities tied to obesity are the chronic conditions you see in your clinic every day. If you're treating high blood pressure, high cholesterol, prediabetes, diabetes, sleep apnea, fatty liver disease, joint pain, low back pain, heart disease, or even certain cancers—those are all linked to obesity.

A failure to adequately address obesity is really a failure to address much of the chronic disease we face. Fixing obesity fixes a lot of other problems, because it’s upstream. Improving energy balance for patients has an enormous impact on their overall health—even if it requires a moderate upfront investment of time and energy. The payoff is huge.

Also, primary care physicians already manage diabetes, and these medications are also used for that. So these are not brand new, unfamiliar therapies. I would encourage providers to invest a little time to understand them. Of course, there are obesity medicine specialists for more complicated cases—but just like you don’t refer every patient with osteoarthritis to an orthopedic surgeon, we shouldn’t be referring every patient with obesity to an obesity medicine specialist. Primary care is, for better or worse, ideally positioned to help patients with their weight, especially knowing how closely it's tied to overall health.

Jonathan Bonnet, MD, MPH, is the program director of medical weight loss at the Clinical Resource Hub Weight Management Center at Palo Alto Veteran's Affairs in Palo Alto, California. He is also an associate professor (affiliate) at Stanford University School of Medicine, and serves on the board of the American Board of Lifestyle Medicine. Bonnet is board-certified in family, sports, obesity, and lifestyle medicine.

For more from our conversation with Bonnet, see: