【编者按】

肥胖是一种慢性、进行性、复发性疾病，在全球范围内的发病率仍呈上升趋势。胰高糖素样肽-1受体激动剂（GLP-1RA）等新型药物有效提升了体重降幅，但如何延长给药间隔、减少注射负担以提高治疗依从性，仍是目前临床面临的重要挑战。近期举行的欧洲糖尿病研究协会（EASD）年会公布了多项前沿药物的重磅研究数据，为肥胖长期管理注入新循证。其中，我国原研博凡格鲁肽是一种每两周给药一次的GLP-1RA，相关研究进展引发中外专家广泛关注。并且其减重适应症新药上市申请已正式获得受理，有望成为全球首款上市的GLP-1RA双周减重制剂。

本期特邀北京大学人民医院纪立农教授、上海市第十人民医院曲伸教授、墨西哥国家医学与营养科学研究院Roopa Mehta教授、南非Sunward Park医疗中心Angela Murphy医生、南非开普敦减重诊所Wayne May医生共话肥胖治疗新进展，展望中国原研博凡格鲁肽在肥胖患者临床治疗中的重要价值与前景。

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Editor’s Note：Obesity is a chronic, progressive, and recurrent disease, with its prevalence continuing to rise globally. While novel pharmacotherapies such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have substantially improved weight reduction, extending dosing intervals and reducing injection burden to enhance treatment adherence remain key clinical challenges. At the recent annual meeting of the European Association for the Study of Diabetes (EASD), landmark data on multiple investigational drugs provided renewed evidence for the long-term management of obesity. Among these, Bofanglutide — a Chinese-developed GLP-1 RA administered twice-monthly — drew broad attention from experts both in China and abroad. In addition, its new drug application for the weight-loss indication has been accepted for review, positioning Bofanglutide to become the world’s first GLP-1 RA for weight loss with twice-monthly dosing interval to reach the market.

In this special edition, we are privileged to bring together Professor Linong Ji (Peking University People's Hospital), Professor Shen Qu (Shanghai Tenth People's Hospital), Professor Roopa Mehta (National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico), Doctor Angela Murphy (Sunward Park Medical Centre, South Africa), and Doctor Wayne May (Cape Town Bariatric Clinic, South Africa) to share their perspectives on the latest advances in obesity treatment and explore the clinical value and future promise of China's innovative Bofanglutide for patients living with obesity.

跨越大洋，共商“减”法：中墨专家共话肥胖治疗新进展

Across the Ocean, Charting a New Course in Weight Management: Chinese and Mexican Experts Discuss the Latest Advances in Obesity Treatment

EASD焦点丨一场关于肥胖的跨洋对话，为何全球专家都在关注这种GLP-1RA双周制剂？

Roopa Mehta教授

墨西哥数据显示成人中的超重和肥胖比例已突破75%[1]，其中年轻群体（40岁以下）占比明显。这类早期肥胖人群面临更高的2型糖尿病（T2DM）、高血压等代谢性疾病风险。当前墨西哥的首要任务之一是强化肥胖是一种慢性疾病的认知，进行长期、多学科的慢病管理。

纪立农教授

肥胖不仅是墨西哥的难题，也是中国面临的严峻挑战。研究显示[2]，中国超重和肥胖患病率已超50%，且预计至2030年将攀升至70%。正如Roopa教授所说，需要增强肥胖是一种慢性疾病的认知；同时，针对已确诊的肥胖人群应实施精准干预，以降低合并症风险。得益于新型药物治疗的突破，目前临床治疗可以实现超过10%甚至15%的体重降幅，还能有效促进糖尿病的缓解，改善心血管临床结局。

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Idiabetes: In 2026, the journal Nature published a global report on obesity epidemiology, revealing that developing countries are experiencing an accelerated rise in obesity rates. Could you please share—drawing on the specific characteristics of populations in China and Mexico—the progress made in obesity treatment to date, as well as the unmet needs that remain?At the same time, how can we raise awareness of the condition among the global population affected by obesity and move toward long-term health?

Professor Roopa Mehta：Data from Mexico show that the combined prevalence of overweight and obesity among adults has surpassed 75%[1], with a notable proportion seen in younger populations under 40 years of age. These individuals with early-onset obesity face elevated risks of metabolic diseases, including type 2 diabetes (T2DM) and hypertension. One of Mexico's current priorities is to strengthen the recognition of obesity as a chronic disease and to implement long-term, multidisciplinary chronic disease management.

Professor Linong Ji：Obesity is not only a challenge for Mexico, but also a pressing public health issue in China. Research shows that the combined prevalence of overweight and obesity in China has exceeded 50% and is projected to rise to 70% by 2030[2]. As Professor Roopa highlighted, it is essential to reinforce the recognition of obesity as a chronic disease; in parallel, targeted interventions should be implemented in individuals already living with obesity to reduce the risk of comorbidities. Thanks to breakthroughs in novel pharmacotherapies, current clinical treatment can achieve weight reductions of more than 10%, or even 15%, while also effectively promoting diabetes remission and improving cardiovascular outcomes.

国际糖尿病：近年来，中国减重药物研发持续领跑。我国原创、有望成为全球首个的GLP-1RA双周减重制剂博凡格鲁肽，也多次亮相国际舞台，请您结合其机制特点，分享下特点及临床价值？

纪立农教授

随着中国创新药物发展加速，肥胖等代谢性疾病成为重点关注领域。以甘李药业为代表的制药企业及新兴生物技术公司正积极投入相关新药研发，相较于临床常用的司美格鲁肽、埃诺格鲁肽等每周1次GLP-1受体激动剂，中国原研博凡格鲁肽通过延缓药物的吸收和降解，实现每两周给药一次。目前博凡格鲁肽在中国成年肥胖/超重人群中开展的Ⅲ期GRADUAL-1研究结果公布，结果显示：治疗52周后，博凡格鲁肽48 mg组受试者体重较基线平均降低近19%。安全性方面，博凡格鲁肽的耐受性和安全性良好，不良反应类型与已上市GLP-1受体激动剂类药物已知安全性特征一致，其中的胃肠道反应大多为轻度或中度，且多为一过性，未发现新的安全性信号。期待未来能够早日临床获批，让更多患者获益。

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Idiabetes: In recent years, China has continued to lead the way in the research and development of weight-loss medications. Bofanglutide, which is positioned to become the world’s first GLP-1 RA for weight loss with twice-monthly dosing interval to reach the market, has also frequently appeared on the international stage. Could you please discuss its mechanism of action, key characteristics, and clinical value?

Professor Linong Ji：With the accelerated development of innovative drugs in China, metabolic diseases such as obesity have become a key priority area. Pharmaceutical companies such as Gan & Lee Pharmaceuticals, along with emerging biotech companies, are actively investing in new drug development. Compared with commonly used once-weekly GLP-1 receptor agonists such as semaglutide and ecnoglutide, Bofanglutide, an original drug developed in China, allows for twice-monthly dosing by slowing drug absorption and degradation. Topline results from the Phase Ⅲ GRADUAL-1 study of Bofanglutide in Chinese adults with obesity/overweight have recently been reported: after 52 weeks of treatment, participants in the Bofanglutide 48 mg group achieved a mean body weight reduction of 18.54% from baseline. In terms of safety, Bofanglutide demonstrated favorable tolerability and a well-characterized safety profile. The types of adverse reactions observed are consistent with the known safety characteristics of other GLP-1 receptor agonists already on the market. Common gastrointestinal reactions are mostly mild to moderate in severity and generally transient, with no new safety signals identified. We look forward to its timely regulatory approval, which would enable more patients to benefit from this promising therapy.

国际糖尿病：目前博凡格鲁肽已经与墨西哥知名药企达成合作，有望为拉丁美洲地区肥胖患者带来新的治疗可能。与单周制剂相比，双周制剂在肥胖症治疗中具有哪些独特的临床价值？对于已经达到减重目标的患者，应如何进一步优化治疗策略，以实现体重的长期维持？

Roopa Mehta教授

对于肥胖患者而言，达到减重目标后成功维持这一成果，是预防远期不良结局、实现长效获益的关键。目前而言，维持阶段的一大难点在于患者普遍存在停药误区：常误以为减重达标即可停药。因此，我们需要向大众和患者强调一个核心观念：肥胖是一种需要长期管理的慢性疾病，维持治疗是不可或缺的环节。一旦患者达到减重目标，便可考虑调整给药方式等策略制定个性化的维持方案。而新型药物博凡格鲁肽实现每两周仅给药一次，有助于提升患者的治疗依从性，这对于中国及全球肥胖患者的体重维持，都将是一种新的潜在选择。

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Idiabetes: Bofanglutide has entered into a partnership with the renowned Mexican pharmaceutical company, offering the potential for new treatment options for patients with obesity in Latin America. Could you share your insights on the unique clinical value of the twice-monthly formulation compared to once-weekly formulations in the treatment of obesity? For patients who have already achieved their weight loss goals, how should treatment strategies be further optimized to ensure long-term weight maintenance?

Professor Roopa Mehta：For patients with obesity, successfully sustaining weight loss after achieving treatment goals is critical to preventing long-term adverse outcomes and securing durable benefits. Currently, one of the key challenges in the maintenance phase is the widespread misconception among patients that treatment can be discontinued once the weight target is reached. We must therefore emphasize a core concept to both the public and patients: obesity is a chronic disease that requires long-term management, and maintenance therapy remains an indispensable component. Once patients achieve their weight-loss goals, strategies such as adjusting the dosing regimen can be considered to develop individualized maintenance plans. The novel agent Bofanglutide, with twice-monthly injection, offers the potential to improve treatment adherence—representing a promising new option for weight maintenance in patients in China and around the world.

Roopa Mehta教授

纪立农教授

正如Roopa教授所强调的，肥胖作为一种慢性疾病，需要长期的生活方式干预与药物治疗，并且依从性是重要挑战之一。基于这一共识，结合博凡格鲁肽的良好耐受性，我们期待其临床应用，以改善患者的治疗意愿与依从性。此外，我们将在进一步开展真实世界研究，以评估其双周给药方案能否进一步提高患者长期治疗的依从性。

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Idiabetes: Among the many factors involved in formulating treatment strategies for obese patients, what is the primary factor you consider?

Professor Roopa Mehta：When evaluating the clinical value of weight-loss pharmacotherapies, particularly novel agents, efficacy and safety remain our primary focus. Bofanglutide, which is positioned to become the world’s first GLP-1 RA for weight loss with twice-monthly dosing interval to reach the market, demonstrated a favorable safety and tolerability profile in Phase Ib/IIa studies and confirmed the feasibility of this dosing regimen. Its weight-lowering efficacy was clearly established in Phase IIb trials, and the Phase III GRADUAL-1 study confirmed its effectiveness in Chinese adults with overweight or obesity. Moving forward, we plan to further explore its clinical potential, including its effects on comorbidities such as fatty liver disease, cardiovascular conditions, and obstructive sleep apnea syndrome. In addition, a Phase III study in the Mexican population is being planned to expand the applicability of this therapy to a broader patient population.

Professor Linong Ji：As Professor Roopa emphasized, obesity is a chronic disease that requires long-term lifestyle intervention and pharmacological treatment, with adherence representing one of the key challenges. Based on this consensus, and given the favorable tolerability profile of Bofanglutide, we look forward to its clinical availability to improve patients' treatment motivation and adherence. Furthermore, we will conduct further real-world studies to assess whether its twice-monthly dosing regimen can enhance long-term treatment adherence in real-word study.

Roopa Mehta教授

随着新型药物的不断涌现，临床决策不仅需要评估药物的减重疗效，还需综合考量副作用、给药方式等因素，并进行个体化匹配。其中，博凡格鲁肽减重显著、安全性及耐受性良好，特别是其每两周仅需一次注射的给药方式，有效降低了治疗负担，有望成为肥胖患者极具前景的治疗方案。

纪立农教授

既往传统生活方式干预的减重幅度约为5%，未能满足肥胖患者的治疗需求。GLP-1受体激动剂的出现，不仅革新了临床对肥胖的管理模式，更促使医学界重新审视其生理病理机制——肥胖不再是单纯的个人意志问题，而是一种需要生物学手段干预的病理状态。这也意味着，临床医生不仅要掌握GLP-1类药物，更须具备长期管理的综合能力。未来，我们亟需凝聚多方共识，推动肥胖管理成为现代医学的重要学科，在改善患者生活质量的同时降低疾病进展风险。中墨两国的临床实践形成优势互补，我们期望能与Roopa教授及墨西哥学界携手，将博凡格鲁肽等新型药物正确、规范地应用于临床实践。

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Idiabetes: Given the wide array of available GLP-1 RAs, how should clinicians make their selection? Furthermore, how should personalized, long-term treatment strategies be formulated for patients with obesity?

Professor Roopa Mehta：With the continuous emergence of novel pharmacotherapies, clinical decision-making requires not only an evaluation of weight-loss efficacy, but also careful consideration of adverse effects, dosing regimens, and other factors—culminating in an individualized treatment match. Among these agents, Bofanglutide stands out for its significant weight reduction, favorable safety and tolerability profile, in particular, its twice-monthly injection schedule that effectively reduces treatment burden. It therefore represents a highly promising therapeutic option for patients living with obesity.

Professor Linong Ji：Historically, lifestyle intervention alone achieved only approximately 5% weight reduction, which fell short of meeting the treatment needs of patients with obesity. The advent of GLP-1 receptor agonists has not only revolutionized the clinical management paradigm for obesity, but also prompted the medical community to re-examine its pathophysiological basis—obesity is no longer viewed simply as a matter of personal willpower, but rather as a pathological condition requiring biological intervention. This shift also means that clinicians must not only master GLP-1-based therapies, but also develop comprehensive capabilities for long-term disease management. Going forward, it is imperative to build multidisciplinary consensus and advance obesity management as an important discipline in modern medicine, with the dual goals of improving patients' quality of life and reducing the risk of disease progression. China and Mexico have complementary clinical practices, and we look forward to working hand in hand with Professor Roopa and the Mexican academic community to ensure that novel therapies such as Bofanglutide are applied correctly and appropriately in clinical practice.

万里同心，共启“轻”程：中国南非携手开启体重管理新篇章

Across Thousands of Miles, Embarking on a 'Lighter' Journey: China and South Africa Join Hands to Open a New Chapter in Weight Management

EASD焦点丨一场关于肥胖的跨洋对话，为何全球专家都在关注这种GLP-1RA双周制剂？

国际糖尿病：为什么肥胖症患者的体重管理需要长期甚至终身进行？在GLP-1RA创新减重药物不断问世，并已取得明确减重疗效的当下，临床上仍有不少患者难以坚持治疗。您认为，影响患者进行长期治疗的主要原因有哪些？面对以上因素，您认为可能的解决方案是什么？

曲伸教授

当前医学界已达成共识：短期干预难以维持减重成果，肥胖管理需要早期干预、联合治疗以及更长的治疗时间。然而真正的长期维持治疗仍面临诸多现实挑战：首先，药物作用机制需要更为丰富；其次，副作用仍是导致患者依从性下降、治疗中断的重要因素。更为关键的是，肥胖治疗的认知亟需转变——需要破除“减重达标即成功”的误区。长期维持体重稳定、避免反弹的关键，在于使患者深入理解治疗策略，并认识到需要药物干预与生活方式改变深度融合。此外，临床医生应重视副作用的沟通和管理，避免因不良反应而中断治疗。总体而言，提升治疗的持久性，不仅需要依靠药物疗效，更需优化长效给药策略、降低治疗负担。

Angela Murphy医生

我们的重要任务之一是重塑大众认知，应摒弃为审美及短期健康而减重的观念。目前已经证实，肥胖是一种由遗传等多因素驱动的慢性疾病，减重期间人体会产生饥饿感增加、基础代谢率下降等“代谢适应”，这并非个人意志力问题。因而在营养指导、运动规划以及压力与睡眠管理等举措之外，需要辅以长期药物治疗作为保障。此外，也需要改善药物的临床可及性与治疗成本等现实因素。结合患者意愿共同决策，有助于提升临床依从性，也为长期治疗的持续优化奠定了基础。

Wayne May医生

肥胖患者体重反复的重要因素之一在于食欲失调。随着体重减轻，机体会增加食欲，致使单纯依赖饮食与运动的干预失败。因此若想真正战胜肥胖，需要通过药物等医学手段精准干预食欲失调这一重要因素。这些情况也需要与患者深入沟通，从而让患者依从并坚持长期治疗。在肥胖的长期管理中，临床实践通常分为强化治疗期和减重维持期。强化治疗期的核心在于积极干预并妥善管理副作用；而当患者减重达标后进入维持期，则面临更为艰巨的依从性挑战。成功的关键不仅在于前期的沟通，更依赖于治疗策略的选择。减少治疗成本、给药频率等，已成为维持减重效果的重要考量因素。

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Idiabetes: Why does weight management for patients with obesity require a long-term—or even lifelong—approach? Even as innovative GLP-1 RA weight-loss drugs continue to emerge and demonstrate clear efficacy, many patients still struggle to adhere to treatment in clinical practice. In your view, what are the primary factors affecting patients' ability to maintain long-term treatment?

Professor Shen Qu：The medical community has now reached a consensus that short-term intervention alone is insufficient to sustain weight-loss outcomes, and that obesity management requires early intervention, combination therapy, and a longer treatment duration. Nevertheless, true long-term maintenance therapy still faces considerable real-world challenges. First, a more diverse range of drug mechanisms of action is needed. Second, adverse effects remain a major factor contributing to reduced adherence and treatment discontinuation. Most importantly, the perception of obesity treatment itself must evolve—we need to dispel the misconception that "reaching the weight-loss target equals success." The key to maintaining long-term weight stability and preventing regain lies in helping patients fully understand their treatment strategies and recognize the necessity of deep integration between pharmacological intervention and lifestyle modification. Furthermore, clinicians should place greater emphasis on communicating and managing adverse effects to avoid treatment interruption. Overall, enhancing treatment persistence depends not only on drug efficacy, but equally on optimizing long-acting dosing strategies and reducing treatment burden.

Doctor Angela Murphy：One of our key priorities is to reshape public perception and move away from the notion that weight loss is solely for aesthetic purposes or short-term health gains. It is now well established that obesity is a chronic disease driven by multiple factors, including genetics. During weight loss, the body undergoes metabolic adaptations—such as increased hunger and reduced basal metabolic rate—which are not a reflection of personal willpower. Therefore, alongside nutritional counseling, exercise planning, and stress and sleep management, long-term pharmacological treatment should be provided as an essential component of care. In addition, practical barriers such as drug accessibility and treatment costs must be addressed. Shared decision-making that incorporates patients' preferences can help improve clinical adherence and lay the groundwork for the continued optimization of long-term management.

Doctor Wayne May：A key factor contributing to weight regain in patients with obesity is appetite dysregulation. As weight is lost, the body responds by increasing appetite, which often causes interventions based solely on diet and exercise to fail. Therefore, truly overcoming obesity requires precise medical intervention—such as pharmacotherapy—to target this fundamental driver. These considerations need to be communicated in depth with patients to encourage adherence and persistence with long-term treatment. In the long-term management of obesity, clinical practice is typically divided into an intensive treatment phase and a weight-loss maintenance phase. The intensive phase focuses on proactive intervention and the careful management of adverse effects. After patients achieve their weight-loss goals and enter the maintenance phase, however, adherence becomes an even greater challenge. Success depends not only on early communication, but also, crucially, on the choice of treatment strategy. Reducing treatment costs and dosing frequency has become an important consideration for sustaining weight-loss outcomes.

Angela Murphy医生

随着经济发展，南非肥胖率呈现爆发式增长；然而多样的文化背景，使各族群对肥胖的认知大相径庭。既往爆发的艾滋病使得大众对消瘦抱有病耻感，导致社会潜意识中将“丰满”与健康、富足相挂钩，甚至认为肥胖属于正常体型。面对这种现实，临床医生需要充分考虑患者个人意愿与临床因素。

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Idiabetes: Given the diverse cultural backgrounds and dietary habits, what are the key characteristics of patients' overall perceptions regarding obesity and weight loss? In the current South African healthcare landscape, what factors do physicians typically prioritize when formulating personalized treatment plans?

Doctor Angela Murphy：With economic development, South Africa has witnessed a dramatic surge in obesity rates. However, diverse cultural backgrounds have shaped markedly different perceptions of obesity across ethnic groups. The legacy of the HIV/AIDS epidemic has fostered a stigma around thinness, leading society to subconsciously associate a fuller figure with health and prosperity—and in some cases, even to regard obesity as a normal body type. Given this reality, clinicians must carefully consider both patients' individual preferences and clinical factors when making treatment decisions.

Wayne May医生

肥胖的药物治疗策略从每日一次到每周一次，再到两周给药一次，契合了患者对于减少用药负担的诉求。相较于既往每周一次方案，双周制剂使患者的注射次数减半，能够更好地兼容治疗与个人日程。当患者达到减重目标，长期的体重维持便成为当务之急，更希望负担更低的给药策略。双周制剂博凡格鲁肽不仅能实现有效减重，还能提升长期治疗的接受度，对于巩固治疗成果、提高患者依从性具有重要意义。

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Idiabetes: Could you please share your insights on the unique clinical value of the twice-monthly formulation compared to the once-weekly formulation in the treatment of obesity? For patients who have already achieved their weight loss goals, how should treatment strategies be further optimized to ensure long-term weight maintenance?

Doctor Wayne May：The evolution of pharmacological treatment for obesity—from once-daily dosing to once-weekly, and now to twice-monthly administration—reflects patients' growing demand for a reduced treatment burden. Compared with established once-weekly regimens, twice-monthly formulations halve injection frequency, allowing treatment to integrate more seamlessly with patients' personal schedules. After achieving weight-loss targets, long-term weight maintenance becomes the overriding priority, and lower-burden dosing strategies become even more desirable. As a twice-monthly formulation, Bofanglutide not only delivers robust weight reduction, but also enhances acceptance of long-term therapy—an important step toward consolidating treatment gains and improving patient adherence.

国际糖尿病：您作为通讯作者的2026版中国《肥胖患者的长期体重管理及药物临床应用指南》更新，其中纳入了多种GLP-1RA类药物，您认为双周制剂的独特优势有哪些？能够为临床带来哪些方面的改善？

曲伸教授

近年来新型减重药物发展迅速，我们指南编写组也加快更新频率，并强调了长期管理的重要地位。受生理机制影响，患者可能出现体重反弹；因此需要确保患者遵循指南、提升长期依从性。在此背景下，博凡格鲁肽凭借简化的双周给药，以及一年内九成以上患者能够实现＞5%的减重（Ⅲ期研究中的博凡格鲁肽24mg、48mg组减重≥5%比例分别91.8%、98.1%），强化了患者减重信心；长期治疗或能达到并维持更优的减重目标（如15%甚至18%的减重目标），进而降低代谢紊乱等风险。未来，博凡格鲁肽有望成为一线治疗方案，并帮助患者长期维持减重效果。

Wayne May医生

减重治疗的依从性是确保长期获益的前提。数据显示，高达50%的患者会在首年出现停药现象[3]，而简化用药策略是改善依从性的重要路径。相比于每日或每周给药，每两周给药一次的博凡格鲁肽降低了患者治疗负担，使长期坚持变得切实可行。

Angela Murphy医生

当新型减重药物进入南非市场时，保障药物可及性至关重要。在实际临床中，库存短缺是导致患者治疗中断的重要障碍，断货可能使其丧失治疗兴趣与依从性。此外，药物价格同样深刻影响着临床可及性。若新型药物的价格具备市场竞争力，能够为患者提供明确的长远获益，有助于患者将其视为一项长期的健康投资并提前规划。

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Idiabetes: As the corresponding author for the Guideline for Long-Term Weight Management and Clinical Use of Anti-Obesity Medications in Patients with Obesity(2026 edition)—which incorporates various GLP-1 RAs—what do you consider to be the unique advantages of the twice-monthly formulation?

Professor Shen Qu：In recent years, the rapid development of novel anti-obesity medications has prompted our guideline writing group to accelerate the frequency of guideline updates, with an increased emphasis on the importance of long-term disease management. Due to physiological mechanisms, patients may experience weight regain over time; it is therefore essential to ensure patients adhere to guideline recommendations and maintain long-term treatment persistence. In this context, Bofanglutide—with its twice-monthly dosing regimen and proven efficacy—strengthens patients' confidence in weight loss. In the Phase III study, the proportion of patients achieving ≥5% weight reduction was 91.8% and 98.1% in the Bofanglutide 24 mg and 48 mg groups, respectively. Long-term treatment with Bofanglutide may enable patients to achieve and sustain more ambitious weight-loss targets, such as 15% or even 18% reduction, thereby reducing the risk of metabolic disturbances and related comorbidities. Looking ahead, Bofanglutide has the potential to become a first-line therapeutic option, helping patients maintain durable weight-loss benefits over the long term.

Doctor Wayne May：Adherence to weight-loss treatment is a prerequisite for ensuring long-term benefits. Data show that up to 50% of patients discontinue therapy within the first year[3], and simplifying dosing strategies represents a key pathway to improving adherence. Compared with daily or weekly administration, Bofanglutide—with its twice-monthly dosing—reduces patient treatment burden, making long-term persistence a more practical and achievable goal.

Doctor Angela Murphy：As novel anti-obesity medications enter the South African market, ensuring drug accessibility is of critical importance. In real-world clinical practice, supply shortages are a major barrier leading to treatment interruption—when medications are out of stock, patients may lose interest and adherence. In addition, drug pricing profoundly affects clinical accessibility. If new medications are priced competitively and deliver clear long-term benefits, patients are more likely to view them as a long-term health investment and plan accordingly.

Angela Murphy医生

不同个体对GLP-1RA确实存在一定差异，多款药物的减重幅度约20%~28%，但仍需重视临床中的个体化治疗策略。由于不同患者的生理机制与治疗诉求各不相同，丰富药物选择，才能为他们提供合理的治疗方案。

Wayne May医生

不断涌现的新型减重药物——靶点包括GLP-1、GIP等，为我们提供了体重依赖性和非体重依赖性2种路径。大幅减重之外，也能改善多项代谢指标，例如带来肝脏、肾脏、心血管等获益。未来，能够在有效减重同时带来多重代谢获益的新型药物，有望进一步改善患者获益。

曲伸教授

当前，受限于新药机制及成本、可及性现实，临床尚难实现真正的个体化治疗。随着未来更多新机制及给药策略的药物上市，综合治疗与精准筛选将逐步成为可能。肥胖是一种影响多个系统的慢性疾病，亟需突破科室壁垒，凝聚外科、内分泌、妇科、临床营养科等多学科力量，建立统一的多学科协作机制。这不仅有望统一诊疗理念，更是实现高效、精准管理的重要路径。

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Idiabetes: Given the wide array of available GLP-1 RAs, how should clinicians make their selection? Furthermore, how should personalized, long-term treatment strategies be formulated for patients with obesity?

Doctor Angela Murphy：There is indeed considerable inter-individual variability in response to GLP-1 receptor agonists. Although several agents have demonstrated weight reductions of approximately 20%–28%, individualized treatment strategies remain essential. Given that patients differ in their underlying physiological mechanisms and therapeutic goals, expanding the range of available pharmacotherapies is key to enabling rational, tailored treatment plans.

Doctor Wayne May：The continuous emergence of novel anti-obesity medications—targeting pathways such as GLP-1 and GIP—offers two distinct mechanisms of benefit: one dependent on weight loss and one independent of weight. Beyond substantial weight reduction, these agents also improve multiple metabolic parameters, including hepatic, renal, and cardiovascular outcomes. Looking ahead, novel therapies that combine effective weight loss with broad metabolic benefits hold great promise for further improving patient outcomes.

Professor Shen Qu：Currently, true individualized treatment remains difficult to achieve in clinical practice, constrained by the mechanisms of available agents and real-world barriers such as cost and accessibility. As more therapies with novel mechanisms of action and innovative dosing strategies become available in the future, comprehensive treatment approaches and precision patient selection will gradually become feasible. Obesity is a chronic disease affecting multiple organ systems, and there is an urgent need to break down departmental silos by bringing together the collective expertise of surgery, endocrinology, gynecology, clinical nutrition, and other specialties to establish an integrated multidisciplinary collaboration framework. Such a framework not only promises to harmonize diagnostic and therapeutic principles, but also represents an essential pathway toward efficient and precision-based obesity management.

The marketing application for the weight-loss indication of Bofanglutide has been accepted but not yet approved; the data provided are from clinical studies.

博凡格鲁肽减重适应证上市申请已获受理、尚未获批，数据为临床研究数据。

Reference：

参考文献：

1.Shamah-Levy T, et al. Cuernavaca, Mexico: National Institute of Public Health, 2024.

2.Hu J, et al. The Lancet Regional Health – Western Pacific, 2026, 68.

3.Wilding J, et al. ECO 2026, Istanbul. PO4.005.

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