Pharmacists Weigh Health, Not Just Weight, in Obesity Care

At the New England Institute of Ambulatory Care Pharmacists (NEIAP) 2026 Annual Forum in Boston, Massachusetts, Jennifer Goldman, PharmD, CDCES, BC-ADM, FCCP, professor of pharmacy practice at the Massachusetts College of Pharmacy and director of cardiometabolic services at Well Life Medical in Peabody, Massachusetts, discussed how pharmacists should approach titration of glucagon-like peptide-1 (GLP-1) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists and how to identify the strongest candidates for anti-obesity medications.

Goldman said a common misconception is treating titration as a push toward the highest dose. Instead, she emphasized reaching the dose that is most appropriate for the individual—one the patient can tolerate without problematic side effects. Dose escalation, she said, is not a race; if a patient experiences side effects, there is no need to escalate right away. The priority is what the patient can tolerate and what best supports their overall health rather than a number on a scale.

Goldman spoke to dose selection, saying that the decision should start from the big picture and the goal for that specific patient. Rather than focusing on weight alone, she looks at overall health and whether the patient has comorbid conditions that may benefit from these agents. She specifically cited atherosclerotic cardiovascular disease, heart failure, chronic kidney disease, liver fibrosis, and obstructive sleep apnea as conditions that shape candidacy.

Framing obesity care as being about health as much as weight loss, Goldman positioned the pharmacist as well suited to integrate guideline recommendations with a patient's cardiometabolic comorbidity profile. Together, her points reframe anti-obesity therapy around tolerability and whole-person health, with the pharmacist matching therapy to the conditions most likely to benefit.