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The American Geriatrics Society has published a case-based framework for clinicians prescribing obesity medications, including GLP-1 therapies, to older adults. It emphasizes assessing function, nutrition and cognition, and pairing treatment with measures such as resistance training and adequate protein intake.
The American Geriatrics Society (AGS) has published a case-based framework to help clinicians make individualized prescribing decisions about obesity medications for older adults, including GLP-1 medicines. The guidance highlights age-related concerns such as frailty, muscle loss, malnutrition and dehydration, and calls for assessing patients’ function, nutrition and cognition before treatment.
The paper, developed by the AGS Healthy Aging Special Interest Group and published in the Journal of the American Geriatrics Society, applies the organization’s Geriatrics 5Ms Framework to incretin-based obesity treatments. Its five areas are Mind, Mobility, Medications, Multicomplexity and Matters Most, a structure intended to connect treatment choices with an older adult’s health, circumstances and priorities.
The authors describe obesity medications as potentially offering benefits for weight management and glycemic control, among other health conditions. But they point out that older adults are underrepresented in clinical trials, making careful consideration of risks and individual circumstances particularly relevant when clinicians discuss treatment.
The framework recommends checking functional status, nutritional adequacy and cognitive impairment before prescribing, in line with guidance on pairing obesity medications with healthy habits. It also advises pairing medication with supportive measures, including resistance training and sufficient dietary protein. Depending on the person’s needs, care may involve a registered dietitian, physical therapist, fitness trainer or behavioral health professional, the paper says.
Balancing Weight Treatment With Function
The framework addresses a practical challenge in treating older adults: weight management is not the only consideration when choosing a medication. Clinicians also need to account for mobility, strength and nutritional health, as well as other conditions and medicines. The AGS authors identify potential concerns including lean muscle loss, frailty, malnutrition and dehydration.
For patients and clinicians, the approach makes the decision broader than whether a medicine could help reduce weight or improve blood sugar. A pretreatment review and supportive care could help make treatment plans more responsive to a person’s functional needs and priorities. The report offers a framework for those discussions; the source does not describe it as a clinical trial or provide evidence that following it produces particular patient outcomes.
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A Geriatrics-Based Prescribing Approach
The paper centers on incretin therapy, which includes GLP-1 medications that work through gut-derived hormonal pathways. These drugs have been discussed for weight management and other health conditions, but evidence from clinical trials may not fully represent older adults because, as the authors note, that population is underrepresented in trials.
The AGS 5Ms framework is designed to organize care around multiple aspects of aging rather than a single diagnosis. In this paper, the authors use it to bring cognitive health, mobility, medication use, complex health needs and a patient’s own priorities into prescribing decisions. The publication is Elias M. Wisdom and colleagues’ Obesity Medications in Older Adults: A Geriatrics 5Ms Framework for Safe and Patient-Centered Prescribing, published in 2026, DOI 10.1111/jgs.70769.
“Safe prescribing requires pretreatment assessment of functional status, nutritional adequacy and cognitive impairment.”
— The AGS framework authors, as described in the report
Evidence and Individual Outcomes
The report summary does not provide clinical trial results showing how well the framework works in practice or whether it changes health outcomes. It also does not specify which medication is appropriate for a particular patient, set dosing recommendations, or establish that every older adult taking obesity medication needs the same supports.
The degree to which trial evidence applies to older patients remains a concern, since the authors say older adults are underrepresented in clinical trials. The source does not give figures on that representation or detail how risks may vary among older adults with different levels of frailty, cognitive impairment or nutritional need. Prescribing decisions therefore remain matters for clinicians and patients to make in light of individual health circumstances.
Applying the Framework in Care
The paper’s next step is practical application: clinicians can use the case-based approach and 5Ms categories to guide assessments and conversations before prescribing. The source does not announce a rollout schedule, implementation program or future study. It also does not identify a specific follow-up milestone.
For an individual considering treatment, the framework points toward discussing function, nutrition, cognition and personal priorities with a clinician, along with whether exercise, dietary support or a broader care team would be appropriate. The medication decision should be tailored to the patient rather than inferred from the framework alone.
Key Questions
What did the American Geriatrics Society publish?
The AGS published a case-based framework to help clinicians prescribe obesity medications to older adults in a patient-centered way. It applies the Geriatrics 5Ms framework to incretin treatments, including GLP-1 medicines.
What should clinicians assess before prescribing?
The paper recommends assessing functional status, nutritional adequacy and cognitive impairment. It also highlights age-related concerns such as frailty, muscle loss, malnutrition and dehydration.
What supportive measures does the framework mention?
It recommends pairing medication with resistance training and adequate dietary protein. Depending on a person’s needs, a care team could include a dietitian, physical therapist, fitness trainer or behavioral health professional.
Does the framework show that these medications are safe for every older adult?
No. The report describes guidance for individualized prescribing, not proof of safety or benefit for every patient. It notes that older adults are underrepresented in clinical trials and does not provide outcome data validating the framework.
Source: medicalxpress.com
