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The prevalence of OSA is rising steadily due to the obesity pandemic and is contributed by interacting anatomical, inflammatory, and neuro\u2010respiratory mechanisms. Continuous positive airway pressure (CPAP) remains the gold standard for the management of OSA; however, it does not address underlying obesity or weight\u2010independent pathophysiology. Obesity is an important modifiable risk factor for OSA, as weight loss is associated with resolution\/improvement of the disease. Therefore, growing evidence now supports surgical and medical management of obesity as complementary strategies to improve both body weight and apnea\u2010hypopnoea index (AHI), prompting a paradigm shift towards integrated, multimodal care. Bariatric interventions typically achieve 25%\u201035% total weight loss and yield significant but variable reductions in AHI with remission rates of 50%\u201375%, driven by mechanical unloading, improved ventilatory control, and favorable metabolic and anti\u2010inflammatory effects. However, it is constrained by eligibility, cost, and perioperative risks. Alternatively, Incretin\u2010based therapies, particularly Tirzepatide, achieve 10%\u201322% weight loss and reduce AHI to 12\u201330 events per hour, securing the first regulatory approval for OSA based on the largest trial\u2010level AHI reductions. The recent introduction of several therapeutic agents with excellent weight loss potential has reshaped the management landscape of people with obesity and OSA. This review aims to analyze the literature across surgical, endoscopic, and pharmacological interventions and OSA while proposing an individualized treatment framework integrating weight\u2010loss pharmacotherapy with device\u2010based and structured lifestyle strategies and surgical interventions, tailored to disease phenotypes.<\/jats:p>","DOI":"10.1002\/cdt3.70040","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:38:27Z","timestamp":1773005907000},"page":"100-112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anti\u2010Obesity Pharmacotherapy and Emerging Multimodal Interventions for Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7376-8684","authenticated-orcid":false,"given":"Anish","family":"Preshy","sequence":"first","affiliation":[{"name":"Department of Respiratory and Sleep Medicine Gold Coast University Hospital Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelius J.","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust Boston Lincolnshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Hamid","family":"Nedai","sequence":"additional","affiliation":[{"name":"Department of Public Health Birmingham City University Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0886-5255","authenticated-orcid":false,"given":"Joseph M.","family":"Pappachan","sequence":"additional","affiliation":[{"name":"Faculty of Science Manchester Metropolitan University Greater Manchester UK"},{"name":"Department of Endocrinology Countess of Chester Hospital NHS Trust Chester UK"},{"name":"Department of Endocrinology, Kasturba Medical College Manipal &amp; Manipal Academy of Higher Education Manipal India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2016.07.002"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00063198-200011000-00004"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.5935\/1984-0063.20200056"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsae107"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2025.104014"},{"key":"e_1_2_16_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-038830"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics15091088"},{"key":"e_1_2_16_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103221"},{"key":"e_1_2_16_10_1","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2072-1439.2015.04.52"},{"key":"e_1_2_16_11_1","unstructured":"Sleep Health Foundation.Sleep Health Survey of Australian Adults. 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