Holistic Treatment of Obesity: The Importance of Integrating Pharmacotherapy, Dietary Therapy, and Physical Activity for Effective and Sustained Weight Loss

Abstract

Introduction. Obesity is a chronic, complex, relapsing disease requiring long-term, individualized management. Incretin-based pharmacotherapy has increased the potential for clinically meaningful weight loss, but maintaining outcomes and limiting adverse body-composition changes also require dietary therapy and physical activity. Aim. To assess integration of pharmacotherapy, dietary therapy, and physical activity in long-term obesity treatment. Methods. A narrative literature review covering 2020 - 2026 was conducted, primarily including peer-reviewed publications on adult obesity treatment, as well as guidelines, expert statements, systematic reviews, meta-analyses, and randomized trials. Results. Semaglutide and tirzepatide enable substantial weight loss and improvement in metabolic parameters. Dietary therapy supports adequate nutrient intake during reduced energy consumption, while physical activity, particularly resistance training, may help preserve fat-free mass and improve body composition. Weight regain may occur after pharmacotherapy discontinuation, supporting long-term treatment. Conclusions. Obesity treatment should combine pharmacotherapy, dietary therapy, physical activity, and long-term lifestyle change. Assessment should include body weight, metabolic status, body composition, patient functioning, and outcome maintenance.