The essential role of the physiotherapy profession in incretin-based weight loss

Obesity is a global health concern requiring multidisciplinary approaches for effective management. Incretin-based pharmacotherapies, such as glucagon-like peptide 1 receptor agonists and dual GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonists, have demonstrated significant weight loss outcomes, yet their impact on body composition remains underexplored. Evidence indicates that weight loss with these medications may lead to disproportionate fat-free mass loss, heightening risks of sarcopenia and sarcopenic obesity, which are associated with frailty, comorbidities, and reduced functionality. Exercise, particularly resistance training, has proven effective in preserving fat-free mass and optimising long-term weight maintenance. Physiotherapists are uniquely positioned, as one of the largest professions within the Allied Healthcare Professional workforce, their expertise in exercise prescription, rehabilitation, and behaviour change, has the potential to address these challenges. However, concerningly, much of the guidance around the prescription of incretin-based therapies for weight loss fails to mention the inclusion of physiotherapists in the patient management team, and the impact that they can have on clinical outcomes. This debate article argues for the inclusion of physiotherapy within interdisciplinary teams managing patients on incretin-based pharmacotherapy to optimise their efficacy and promote healthier weight loss. CONTRIBUTION OF THE PAPER.