Pharmacist involvement in overweight and obesity care: An equity-focused systematic review.

Background: Pharmacists increasingly contribute to obesity management, but the equity impact of these interventions remained unexplored in literature. Objective: To examine the characteristics and effectiveness of pharmacist-involved weight-management interventions, their consideration of health equity, and the collaborative models through which pharmacists delivered care. Methods: PubMed, Web of Science, Scopus, and the Cochrane Library were searched for English-language quantitative studies published from 2000 to 2026. Eligible studies included people with overweight or obesity, reported weight-related outcomes, and described at least one PROGRESS-Plus characteristic. Equity variables were assessed according to whether they were reported descriptively, used as control variables, or examined for differential effects. Pharmacist collaboration was classified as disciplinary, multidisciplinary, interdisciplinary, or transdisciplinary. Findings were narratively synthesized. Results: Thirty-two studies were included, including 20 conducted in community pharmacies. Pharmacist activities included lifestyle counseling, anthropometric and cardiometabolic monitoring, medication management, adherence support, and referral. Seventeen studies reported significant improvements in BMI or related outcomes. Age and sex were commonly reported, while place of residence, ethnicity, education, employment, socioeconomic status, and social capital were less consistently examined in baseline characteristics. Only seven studies used PROGRESS-Plus factors as control variables, and seven assessed differential effects. Multidisciplinary care was the most common model (50%), followed by interdisciplinary (25%), disciplinary (19%), and transdisciplinary care (6%). Conclusion: Pharmacist-involved interventions may improve weight-related outcomes, but current evidence is insufficient to determine whether they reduce obesity-related inequalities.