The World Health Organization (WHO) has published its first official guideline on the use of GLP-1 therapy for treating obesity in adults. This step underscores the recognition of obesity as a chronic disease that requires comprehensive and continuous care.
According to WHO data, obesity currently affects more than 1 billion people worldwide, and this number is projected to double by 2030. The organization defines obesity in adults (aged 19 and over) as a Body Mass Index (BMI) of 30 or greater.
However, it is essential to note that these global thresholds do not account for all ethnic and racial differences. For example, in people of Asian descent, the health risk associated with a higher percentage of body fat may increase at a lower BMI (some guidelines define obesity at a BMI of $27.5$), while populations of African descent often have more muscle mass, which can artificially increase their BMI. Therefore, BMI is only an orientational measure, and physicians use additional indicators for a comprehensive assessment of health risk.
The guideline, developed in response to requests from WHO Member States, contains two conditional recommendations regarding the use of GLP-1 receptor agonists (liraglutide and semaglutide) and the dual GIP/GLP-1 agonist (tirzepatide):
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Pharmacological Treatment: A conditional recommendation permits the use of these medications for the long-term treatment of obesity in adults (excluding pregnant women). However, WHO notes that this is a conditional recommendation with moderate certainty, driven by limited data on long-term effectiveness and safety, costs, healthcare system unpreparedness, and potential equity issues.
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Behavioral Therapy: The second recommendation suggests that intensive behavioral therapy can be used as co-treatment within a comprehensive, multimodal clinical algorithm to improve treatment outcomes.
The World Health Organization (WHO) considers new weight-loss medications like GLP-1 therapies to be a “medical breakthrough,” but issues a warning that without targeted policies, their accessibility could worsen existing inequalities in access to healthcare services.
WHO’s Key Calls to Action:
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Equitable Access: WHO calls for strategies (such as pooled procurement and licensing) for the fair distribution of the drugs.
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Comprehensive Approach: The organization stresses that the obesity crisis cannot be solved by medications alone. A systemic response is required, which includes: creating healthier environments through a shift in the political agenda, as well as protecting high-risk individuals and ensuring access to person-centered care.
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Safe Use: WHO adviser, Dr. Chelet, notes that GLP-1 therapies should only be used under clinical indication and physician prescription to avoid the risks of inappropriate use and falsified products.
Experts welcome this guideline, which confirms that obesity is a chronic disease requiring both medical treatment and coordinated public health efforts.
