AUTHOR=Steenackers Nele , Toumazia Julia , Deleus Ellen , Mertens Ann , Lannoo Matthias , Pazmino Sofia , van Laar Amar Daniƫl Emanuel , Van der Schueren Bart , Vangoitsenhoven Roman TITLE=Pharmacotherapy for obesity: are we ready to select, tailor and combine pharmacotherapy to achieve more ambitious goals? JOURNAL=Frontiers in Endocrinology VOLUME=Volume 16 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1569468 DOI=10.3389/fendo.2025.1569468 ISSN=1664-2392 ABSTRACT=Recent advancements in obesity pharmacotherapy have seen the approval of novel agents, like glucagon-like peptide-1 receptor agonist and dual agonists, offering unprecedented efficacy for obesity management. However, treatment outcomes remain highly variable, necessitating a more personalized approach to pharmacotherapy tailored to individual profiles. This review evaluates the current landscape of obesity pharmacotherapy, while exploring factors influencing variability in treatment response including early response predictors, genetic markers, and physiological traits. Additionally, the potential of combining treatment modalities and some emerging drugs are highlighted. Finally, a stepwise algorithm is proposed for personalized obesity treatment, integrating comorbidities, phenotypes, and responses to medication, paving the way for more effective and efficient obesity management.