WHO issues recommendations for weight-loss drugs to treat obesity

The World Health Organization has issued its first guideline on treatments to support millions of people struggling with obesity. The guideline specifically recommends the use of glucagon-like peptide-1, or GLP-1, therapies, a class of drugs that includes tirzepatide, liraglutide, and semaglutide, which are found in popular weight-loss treatments such as Ozempic and Mounjaro. WHO said these therapies may be used by adults — excluding pregnant women — for the long-term treatment of obesity, which has become a serious public health issue now affecting more than 1 billion people globally. WHO defines obesity in adults as having a body mass index of 30 or higher. It adds that intensive behavioral therapies may be offered to adults living with obesity and are prescribed these medications, although there is “low certainty evidence” at the moment to suggest it may improve treatment outcomes. WHO had already added GLP-1 therapies to its essential medicines list back in September for the management of type 2 diabetes. It said the guideline “will be continuously updated and expanded in response to the evolving evidence base and emerging real-world data on safety, feasibility, effectiveness and system-level requirements.” Why is this important? Obesity was associated with 3.7 million deaths in 2024, and that number is projected to double by 2030, according to WHO. Despite that, obesity is still largely seen as a lifestyle issue rather than a chronic disease. In a news release, WHO Director-General Tedros Adhanom Ghebreyesus said the “new guidance recognizes that obesity is a chronic disease that can be treated with comprehensive and lifelong care.” GLP-1 therapies offer multiple benefits. Apart from helping individuals in lowering their blood sugar and supporting weight loss, studies have also shown that they can reduce the risk of heart and kidney complications. One study estimated that universal access to these drugs could reduce global obesity prevalence by 20% and save 28 million lives over five years. Limitations The recommendations are conditional, meaning there are some uncertainties. For example, the experts involved in developing the guidelines require further evidence on the benefits and potential harms associated with longer use of GLP-1 therapies. But due to limited evidence, the experts did not make a specific recommendation on when to discontinue the therapies. According to the WHO document, some of the experts involved proposed a strong recommendation on the guidelines for using GLP-1 therapies for long-term treatment of obesity, but eventually, they decided on a conditional recommendation “based on currently limited long-term data, variability of expectations about weight loss across cultures and context, concern around costs and cost-effectiveness, and equity implications.” The guidelines come amid the expected introduction of generic forms of semaglutide in 2026, when patents for the drug are set to expire in several countries, including India and China, potentially expanding access to the medications as cheaper versions become available. However, WHO warned that “GLP-1 therapies are projected to reach fewer than 10% of those who could benefit by 2030,” even with the anticipated rapid expansion of production of these medicines. The U.N. health agency called on the global community to consider several strategies to expand access, including via pooled procurement, tiered pricing, and voluntary licensing. WHO emphasized that medicines alone won’t solve the problem of obesity. Governments must also create healthier environments for their population, such as through policies and the provision of early interventions for people at high risk of developing obesity.