A major advance is the emergence of metabolic and endotype-targeted pharmacotherapy: longitudinal data demonstrate a dose-dependent relationship between weight change and OSA progression or regression, while randomized trials show that GLP-1-based therapies-particularly dual GLP-1/GIP agonism with tirzepatide-produce large, clinically meaningful reductions in AHI and cardiometabolic risk in obesity-associated OSA. This evidence concerns the gene GIP and obesity due to melanocortin 4 receptor deficiency.