Australia’s first clinical consensus statement on obesity and cardiovascular disease will guide clinicians on managing CVD risk across four pillars and outline when GLP-1RAs are appropriate for those living with overweight or obesity.

Professor Garry Jennings.

The National Heart Foundation of Australia’s recommendations is being presented by consensus committee co-chair Professor Garry Jennings at the 79^th World Health Assembly in Geneva this week.

Speaking ahead of the launch, Professor Jennings said the time was right for an national statement on the treatment to help clinicians navigate emerging approaches to obesity management.

“What we’ve found is that in this rapidly moving area where there have been new treatments become available and new hope for dealing with obesity management in the clinic, that health professionals need a very practical, evidence-based guidance,” he said.

The document covers clinical management across nutrition, physical activity, obesity management drugs and when to recommend surgical intervention to reduce cardiovascular disease risk, with a focus on how to reduce weight stigma and its impacts in the clinic.

As prescriptions for obesity management drugs like GLP-1RAs rocket across the globe, the recommendations clarify when clinicians should suggest pharmacological intervention, backing the use of obesity management medications in the following circumstances:

Endocrinologist Professor Elif Ekinci said it was important clinicians had clear guidance on the use of obesity management medications given the continued flow of RCT data showing the protective benefits of GLP-1RAs.

“Now that all this evidence is building up, it’s important for patients to be aware of the potential benefits and also potential side effects of these medications. The guidelines provide that important information for both patients and their families,” she said.

PBS listing unknowns 

Access to GLP-1RAs for patients living with obesity has continued to be a hot button issue in Australia, however, with no drug currently subsidised for the management of obesity separate to type 2 diabetes.

The guidelines acknowledge none of semaglutide, tirzepatide or liraglutide are available on the PBS for weight management, nor are the oral agents naltrexone or phentermine.

At the end of 2025, the Pharmaceutical Benefits Advisory Committee made a recommendation in favour of listing semaglutide for a subgroup of patients with obesity and established cardiovascular disease [link here].

But there have also been signs that some sponsors may be reluctant to launch their products onto the PBS for new indications. Last month Eli Lilly Australia cast doubt on whether tirzepatide would be listed for obesity management, after walking away from negotiations to list the product for T2D [link here].

Professor Elif Ekinci.

Professor Jennings said it was difficult comment on PBS negotiations.

“All we can say is that we want to see medications or any treatments that are evidence based available to people that need them, and hopefully at minimal cost,” he said.

But he also highlighted the many new variations of obesity management medications currently being developed, which could have future implications for access.

“As far as reimbursement is concerned, the more of these products have become available, proven [and] evidence based, the more competition there’ll be. Hopefully that would help address some of the present barriers.”

Clear steps for nutrition, physical exercise 

The statement also guides clinicians on how to advise patients with obesity, CVD or at a high risk of CVD about nutrition and exercise patterns.

Rather than focusing on specific diets, the recommendation is to guide patients on a “heart healthy” eating pattern.

This includes “a wide variety of foods from all food groups, is naturally low in unhealthy fats, salt and added sugars, and limits discretionary food/beverages to reduce cardiovascular risk”, the statement said.

Regular physical activity was recommended across the course of a day, including a mix of moderate-to-vigorous aerobic activity and resistance training.

“We recommend standard national recommendation of 30 minutes of modern convicts physical activity if you can do it,” Professor Jennings said.

However, he emphasised the guidelines are practical and focus on the capabilities of each patient. “It really only recommends that people do what they can”.

Guiding surgical intervention 

Finally, the consensus sets the standard for when weight loss surgery should be considered.

Referral to specialised obesity services can be considered for patients with or at high risk of CVD who have not seen weight-related health improvements through behavioural or pharmacological interventions.

Adults with CVD or at high risk with a BMI of over 40 kg/m² or 35 kg/m² with at least one comorbidity can be referred for consideration of bariatric surgery.