The time at which anti-obesity medications should be added to an obesity intervention has not been agreed upon in treatment guidelines. Many physicians do not even discuss weight loss unless the patient brings it up, let alone discussing anti-obesity medications. Patients with obesity who enroll in a lifestyle program often stop treatment before there is any discussion of a pharmacologic intervention. To prevent non-responders from dropping out of weight-loss programs, it is crucial that experts identify the optimal time to treat patients more aggressively. The authors suggest that if a patient does not achieve 5% weight loss by 12 weeks of a lifestyle intervention program, anti-obesity medications may be considered. If the patient loses greater than 5% at 12 weeks, physicians may consider deferring anti-obesity medications until problems with maintenance develop. A discussion about weight regain and pharmacotherapy may be appropriate while weight loss is still happening to ensure the patient is aware of the pharmacologic option when needed, given the physiologic forces predisposing to weight regain. The authors suggest that weight loss may be better maintained and even improved with anti-obesity medications. Specific criteria are needed to assist physicians on timing the incorporation of anti-obesity medications in patients with obesity. View article