WHO Issues First Guidelines for GLP-1 Therapies in Obesity Treatment
Table of Contents
The World Health Organization is issuing conditional recommendations for the use of Glucagon-Like Peptide-1 (GLP-1) therapies to combat the global obesity crisis, which currently affects over 1 billion people.
The escalating global health challenge of obesity, linked to 3.7 million deaths worldwide in 2024, has prompted the World Health Organization (WHO) to release its inaugural guideline on utilizing GLP-1 therapies for the treatment of obesity as a chronic and relapsing condition. Projections indicate the number of individuals living with obesity could double by 2030 without significant intervention.
In September 2025, the WHO already added GLP-1 therapies to its Essential Medicines List for managing type 2 diabetes in high-risk populations. This new guideline expands upon that recognition, offering conditional recommendations for their use in supporting individuals with obesity, but emphasizes a holistic approach encompassing healthy diets, regular physical activity, and professional healthcare support.
“Obesity is a major global health challenge that WHO is committed to addressing by supporting countries and people worldwide to control it, effectively and equitably,” stated Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Our new guidance recognizes that obesity is a chronic disease that can be treated with comprehensive and lifelong care. While medication alone won’t solve this global health crisis, GLP-1 therapies can help millions overcome obesity and reduce its associated harms.”
Obesity: A Complex and Costly Disease
Obesity is recognized as a complex, chronic disease and a significant contributor to noncommunicable diseases, including cardiovascular disease, type 2 diabetes, and certain cancers. It also exacerbates the severity of outcomes in patients with infectious diseases. The economic burden of obesity is substantial, with predictions estimating an annual global cost of US$3 trillion by 2030. The WHO guideline aims to mitigate these escalating healthcare costs and associated complications.
Landmark Policy Change: Key Recommendations
The new WHO guidance centers around two key conditional recommendations:
- GLP-1 Therapies for Adults: GLP-1 therapies may be used for the long-term treatment of obesity in adults, excluding pregnant women. While the therapies demonstrate efficacy in treating obesity and improving metabolic health, the recommendation is conditional due to limited long-term data regarding efficacy, safety, maintenance, discontinuation, current costs, insufficient health system preparedness, and potential equity concerns.
- Intensive Behavioral Interventions: Intensive behavioral interventions, including structured programs focused on healthy diet and physical activity, should be offered to adults with obesity who are prescribed GLP-1 therapies. This recommendation is based on limited evidence suggesting it may improve treatment outcomes.
Medication is Not a Singular Solution
The WHO guideline underscores that GLP-1 therapies, while representing the first efficacious treatment option for adults with obesity, are not a standalone solution. Obesity is a multifaceted issue requiring a broader societal response. Addressing the crisis demands a fundamental shift towards a comprehensive strategy built on three core pillars:
- Creating healthier environments through population-level policies promoting health and preventing obesity.
- Protecting individuals at high risk of obesity and related comorbidities through targeted screening and early interventions.
- Ensuring access to lifelong, person-centered care.
Implementation and Access Challenges
The guideline emphasizes the critical importance of equitable access to GLP-1 therapies and the need for health systems to prepare for their implementation. Without deliberate policies, access could widen existing health disparities. The WHO is calling for urgent action regarding manufacturing, affordability, and system readiness to meet global demand.
Even with anticipated production increases, GLP-1 therapies are projected to reach fewer than 10% of those who could benefit by 2030. The WHO is urging the global community to explore strategies to expand access, including pooled procurement, tiered pricing, and voluntary licensing agreements.
The WHO developed this guideline in response to requests from its Member States seeking solutions to the challenges posed by obesity. The process involved extensive evidence analysis and consultation with a diverse range of stakeholders, including individuals with lived experience. This guideline is a central component of the WHO acceleration plan to halt obesity and will be regularly updated as new evidence emerges.
During 2026, the WHO will collaborate with stakeholders to develop a transparent and equitable prioritization framework to ensure those with the greatest need are reached first.
Understanding GLP-1 Therapies and Obesity
The WHO defines obesity as having a Body Mass Index (BMI) of 30 or higher in adults. GLP-1 receptor agonists are a class of medications that lower blood sugar, promote weight loss, reduce the risk of heart and kidney complications, and may even lower the risk of early death in individuals with type 2 diabetes. The guideline specifically addresses the use of liraglutide, semaglutide, and tirzepatide for the long-term treatment of obesity in adults.
Combating Counterfeit Medications
The increasing global demand for GLP-1 therapies has unfortunately led to a rise in falsified and substandard products, posing a threat to patient safety and trust. Ensuring quality requires regulated distribution, prescription by qualified healthcare providers, robust oversight, patient education, and international cooperation to safeguard public health.
