Archives of Obesity and Metabolism (비만대사연구학술지)

The Study of Obesity and Metabolic Syndrome, KAFM (대한가정의학회 비만대사증후군연구회)
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Ethical Challenges in Obesity Treatment: Efficacy, Safety, and the Balance of Risk

비만 치료의 윤리적 쟁점: 효과, 안전성, 그리고 위험의 균형

  • Jinseung Kim (Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine)
  • 김진승 (인제대학교 의과대학 부산백병원 가정의학과)
  • Received : 2026.05.13
  • Accepted : 2026.06.03
  • Published : 2026.06.30
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Abstract

Obesity is a chronic disease associated with increased risks of metabolic disorders, cardiovascular disease, cancer, impaired quality of life, and premature mortality. Recent advances in anti-obesity pharmacotherapy, particularly glucagon-like peptide-1 (GLP-1) receptor agonists and dual GLP-1/glucose-dependent insulinotropic polypeptide receptor agonists, have substantially improved weight-loss outcomes and demonstrated significant cardiometabolic benefits. These developments have shifted the treatment paradigm from a focus on weight reduction to broader improvements in health outcomes. However, the history of anti-obesity medications highlights the importance of balancing treatment efficacy with long-term safety. Several agents, including fenfluramine, sibutramine, and lorcaserin, were withdrawn because of serious adverse events identified during clinical use or post-marketing surveillance. In addition, the emergence of highly effective pharmacotherapies has raised important ethical questions regarding obesity medicalization, lifelong pharmacotherapy, treatment accessibility, health equity, obesity stigma, and the role of social determinants of health. Issues related to patient autonomy and shared decision-making have also become increasingly relevant in the GLP-1 era. This review examines the evolution of anti-obesity treatments, the changing risk-benefit balance of contemporary obesity management, and the major ethical challenges associated with modern obesity care. A balanced approach integrating clinical effectiveness, long-term safety, patient-centered decision-making, and social responsibility is essential to achieve sustainable and equitable obesity treatment.

Keywords

References

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