Beyond GLP-1: Amylin, Glucagon Enter Obesity Care

Robert Kushner, MD, MS, professor emeritus at Northwestern University Feinberg School of Medicine, explained in an interview how clinicians can help patients understand obesity as a chronic disease and where obesity pharmacotherapy is headed. The discussion took place during a Pharmacy Times Continuing Education panel.

Kushner emphasized that many people living with obesity—shaped by stigma from society and even family—believe their weight is a personal failing and that a central part of care is conveying that obesity is instead a chronic, progressive disease. To communicate this, he uses diabetes as a comparator: an underlying biological condition treated with medication and counseling, one that returns if treatment stops. He explained that obesity is biologically driven, with metabolic changes that alter appetite, and that patients who have repeatedly tried to lose weight consistently find their appetite returns because the brain works to defend body weight. His message to patients is that it is not their fault and that help is available, including dietary counseling and pharmacotherapy.

On the therapeutic outlook, Kushner described the current moment as the “end of the beginning.” While glucagon-like peptide-1 (GLP-1) receptor agonists and glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 dual agonists are already available, he sees far more ahead as the field harnesses additional gut hormones—amylin and glucagon—alongside GIP and GLP-1. He anticipates future monotherapies, dual therapies, and tri-therapies that are more effective and that target not only weight but also the liver, heart, pancreas, and kidney. For pharmacists, his framing supports empathetic, biology-based counseling.