Professor Hong Tianpei of Peking University Third Hospital holds that, with the continuous emergence of novel weight-loss medications — such as more potent GLP‑1 agents, GIP/GLP‑1 dual-target and triple-target agonists — clinical decision-making has become increasingly complex. Individualized regimens should be formulated by integrating patient phenotypes, drug mechanisms, weight-loss magnitude, metabolic improvement effects, and safety profiles.
Current pharmacotherapy increasingly emphasizes phenotypic classification based on pathophysiological characteristics (e.g., brain hunger type, gastrointestinal hunger type, emotional hunger type, hypometabolic type) to improve drug matching and weight-loss efficacy. Studies show that phenotype-guided treatment is significantly superior to empirical medication, raising success rates and reducing long-term health and psychological burdens.
Meanwhile, artificial intelligence (AI) is driving the research and development of new anti-obesity drugs. For example, AI is used to screen BRP peptides with potential appetite-suppressing and weight-loss effects, which show comparable efficacy to GLP‑1 agents and may reduce adverse reactions, opening new directions for innovative anti-obesity medications.
Under the precision medicine model, bariatric surgery is also evolving from traditional standardized protocols to more individualized pathways. It requires not only standardized and precise surgical procedures but also in-depth targeting of the underlying causes of obesity based on individual characteristics.
Precision diagnosis and treatment cover multiple dimensions: clear diagnosis, psychological intervention, evidence-based decision-making, multidisciplinary collaboration, precision anatomy, standardized procedures, and enhanced recovery after surgery (ERAS), with emphasis on long-term postoperative follow-up.
Surgical outcomes are influenced by many factors, including obesity-related comorbidities, psychosocial and economic status, genetic background, age, gender, BMI, and biomarkers such as miRNAs, metabolites, and gut hormones. Comprehensive evaluation of these factors helps predict outcomes more accurately and develop individualized plans.
It should be emphasized that, despite advances in medications and surgical techniques, lifestyle intervention remains the foundation of weight management. In particular, resistance training is crucial for maintaining muscle mass and basal metabolic rate, especially when weight-loss therapy may cause muscle loss.
At present, the development of precision obesity treatment is being promoted worldwide. In China, the Implementation Plan for the “Weight Management Year” Campaign (2024) proposes using AI to develop personalized nutrition and exercise programs and promoting weight-management applications based on dynamic data. The China Obesity Alliance is also building a multidisciplinary integrated precision diagnosis and treatment system that systematically combines surgery, pharmacotherapy, and lifestyle interventions.
Internationally, the U.S. National Institutes of Health (NIH) outlined in the 2020–2030 Strategic Plan for Nutrition Research the promotion of precision nutrition through basic research, dietary behavior, life-cycle nutrition, and nutritional alternatives. It aims to address key questions — what to eat, when to eat, how to eat, and why we eat — providing scientific evidence for obesity and chronic disease prevention and control.
The core of precision obesity treatment is patient-centered individualized diagnosis and therapy.
The future goal is to integrate genetic and non-genetic factors to define individual obesity risk, predict disease propensity, and evaluate responses to different therapeutic strategies, thereby selecting the most appropriate interventions.
Precision medicine highlights the combined effects of genetic makeup, epigenetic alterations, and environmental factors in designing differentiated regimens — including interval training, low-protein or low-carbohydrate diets, endurance training, pharmacotherapy, or surgical interventions.
Since obesity is determined by the interaction of genetics, epigenetics, environment, and comorbidities, precision intervention must be built on the comprehensive integration of an individual’s multi-dimensional characteristics.