GLP-1 obesity drugs: The World Health Organization has issued its first guidance on the use of GLP-1 medicines for obesity, giving a conditional green light to the drugs as part of long-term treatment for the disease, which it says now affects more than 1 billion people worldwide.
The recommendation follows months of debate as demand for GLP-1 agonists has surged and governments wrestle with how to fund the expensive medicines within public health systems. Reuters had reported earlier this year that the WHO was preparing to take this step.
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Under the new guideline, adults with obesity, defined as a Body Mass Index (BMI) of 30 or above, may be offered GLP-1 therapies such as semaglutide, tirzepatide and the older agent liraglutide, provided they are not pregnant. A second recommendation says the drugs should be used alongside lifestyle measures, including a healthy diet and regular physical activity, rather than as a stand-alone fix.
WHO Director-General Tedros Adhanom Ghebreyesus said the move “recognizes that obesity is a chronic disease that can be treated with comprehensive and lifelong care,” but stressed that medicines alone will not resolve a crisis driven by factors such as diet, environment and inequality.
Experts also urged caution. Dr. Marie Spreckley of the University of Cambridge said the guidance was appropriately labelled “conditional”, citing unanswered questions over the safety of long-term, high-dose use, the affordability of the drugs and the capacity of health systems to deliver them at scale.
Access is now the central concern. Even with manufacturing ramp-up, the WHO estimates that by 2030, fewer than 10% of people who could benefit from GLP-1 therapies will be able to get them. Tedros warned that without deliberate action on pricing and supply, the medicines risk widening gaps between rich and poor countries, and between wealthier and poorer patients within the same nation.
The guideline builds on a decision in September to add semaglutide and tirzepatide to the WHO Essential Medicines List for managing type 2 diabetes in high-risk groups, while stopping short of endorsing them for obesity at that time. From 2026, the WHO plans to work with governments and other partners to prioritise GLP-1 treatment for people at the highest risk, as the global economic cost of obesity is projected to reach $3 trillion a year by the end of the decade.