GLP-1 receptor agonists have transformed the medical management of overweight and obesity across Europe. The European Association for the Study of Obesity (EASO) recommended in its 2025 framework, published in Nature Medicine, semaglutide and tirzepatide as first-line treatments for obesity, alongside lifestyle interventions and complementary approaches.

These molecules — semaglutide (Wegovy®, Ozempic®), liraglutide (Saxenda®), tirzepatide (Mounjaro®) — have demonstrated documented efficacy on weight loss, with reductions reaching 15 to 20% in certain clinical trials. The European Medicines Agency (EMA) approved a higher 7.2 mg dose of Wegovy® in early 2026, demonstrating average weight loss of 20.7% over 72 weeks, and recently issued a positive opinion for the first oral semaglutide formulation in the European Union.

But behind these average figures lie highly variable individual trajectories. Some patients cannot tolerate the treatment. Others cannot afford it. Others again interrupt it voluntarily after several months and observe a rapid return of appetite. And many, in France, fall outside the reimbursement scope set on May 28, 2026 (effective June 15, 2026), which restricts coverage to patients with BMI ≥ 35 with comorbidity or ≥ 40.

This page offers a reading framework structured around four clinical situations, for patients and healthcare professionals alike. For each, we describe what is physiologically at stake, what the French regulatory context tells us in 2026, and the role that a non-pharmacological complementary approach such as GASTER control® may — or may not — play.

Why SOFFCO.MM 2026 makes this topic central

The SOFFCO.MM 2026 congress — the French and Francophone Society for Bariatric and Metabolic Surgery — takes place in Marseille on May 21 and 22, 2026 at the Parc Chanot Convention Center. This year's official program puts at the center of discussion the topics of combined therapies, the articulation between bariatric surgery and anti-obesity medications, and non-invasive innovations.

This page will be updated after the SOFFCO.MM 2026 congress to integrate the elements presented and the relevant clinical discussions.

What has changed in France in recent months

The landscape of medical management for overweight and obesity has undergone three structuring developments in 2025-2026 that are worth keeping in mind to understand current therapeutic choices.

What this means for patients

From June 15, 2026, eligible patients (BMI ≥ 40, or ≥ 35 with comorbidity) will have access to GLP-1 therapies with public health insurance coverage — a major step forward for the management of severe obesity in France. For all other patients within the marketing authorization range, the cost remains entirely out-of-pocket: approximately €300 per month, a financial barrier that remains one of the main causes of early discontinuation.

Despite this reimbursement, the scope remains narrow: the BMI ≥ 35 threshold de facto excludes the majority of patients with overweight or moderate obesity. For them, the question remains open: what structured options are available outside the reimbursed pharmacological pathway?

What this means for prescribers

The clinician now navigates a clearer environment, but one with two distinct populations: on one side, patients eligible for reimbursed GLP-1 therapies (BMI ≥ 35-40) with a structured hospital-led prescription pathway; on the other side, patients within the marketing authorization range but outside reimbursement criteria (BMI 27-35), for whom the question of structured non-pharmacological options becomes central. This dual landscape has sparked sustained reflection on complementary tools, capable of being positioned upstream of, alongside, or as a relay after GLP-1 therapies, within a structured care pathway.

Four patient situations, four logics

Rather than a binary question — should a GLP-1 be prescribed or not? — clinical practice reveals four distinct configurations, each with its own stakes. The positioning of a complementary mechanical approach is not the same across situations.

Complementary tool — not a substitute. Not an alternative to validated pharmacological treatments or to surgery. Indication, timing of introduction, and duration of use depend on an individualized medical decision.

Two pathways of satiety: hormonal and mechanical

Satiety results from the integration of hormonal, neural, and mechanical signals, which converge toward the cerebral circuits involved in the regulation of food intake. To understand why a mechanical approach can articulate with a GLP-1 therapy — without opposing or replacing it — we must first recall that satiety is not a single signal. Multiple information streams converge at the brainstem to produce the conscious perception of fullness.

This physiological convergence has a practical implication: reinforcing the mechanical signal may amplify the perception of integrated satiety, whether a GLP-1 treatment is in progress, in transition, or has been discontinued. The rationale for complementarity does not rest on opposition between pathways, but on their articulation.

For a scientific deep dive into this convergence — receptors, vagal afferents, central integration — see our dedicated page GLP-1 and satiety: how hormonal and mechanical signals converge.

To dive deeper

This page gives you a general reading framework. Each of the situations described above is the subject of dedicated content on the site, and the underlying physiology is detailed on our scientific pages.

FAQ — GLP-1, GASTER control® and care pathways