The new guidelines underscore two critical priorities: Ensuring equitable access to GLP-1 therapies and preparing healthcare systems for the effective implementation and widespread use of these powerful medicines.
It follows the WHO’s earlier move to incorporate GLP-1-based therapies into its Essential Medicines List for the treatment of type 2 diabetes among high-risk patient groups.
Taking a further step, the latest recommendations advise that GLP-1 agents, which include established treatments such as semaglutide, tirzepatide, and liraglutide, may now be utilised for the long-term treatment of adults living with obesity.
With the new guidelines, the WHO aims to support people living with obesity in overcoming this serious health challenge, as part of a comprehensive approach that includes healthy diets, regular physical activity and support from health professionals.
The guidelines are on the basis of two major tenets, one that GLP-1 therapies may be used by adults, but excluding pregnant women, for the long-term treatment of obesity.
“While the efficacy of these therapies in treating obesity was evident, the recommendation is conditional due
to limited data on their long-term efficacy and safety, maintenance and discontinuation, their current costs, inadequate health system preparedness and potential equity implications,” the WHO said.
The other is offering intensive behavioural interventions involving healthy diet and physical activity to adults living with obesity prescribed GLP-1 therapies.
While such therapies represent the first efficacious treatment option for adults with obesity, the WHO guideline also emphasises that medicines alone will not solve the problem.
“Addressing obesity requires a fundamental reorientation of current approaches to a comprehensive strategy which includes creating healthier environments through robust population-level policies, protecting individuals at high risk of developing obesity and ensuring access to lifelong, person-centred care,” the guidelines added.
Obesity affects more than 1 billion people globally and was associated with 3.7 million deaths worldwide in 2024.
“Without decisive action, the number of people with obesity is projected to double by 2030,” the global health body said.
The guidelines come at a time when several medical practitioners have been seeing a demand from patients not eligible for the drugs.
According to standard guidelines for obesity management medications (OMMs), a patient must have a Body Mass Index (BMI) of over 27 with at least one obesity-related comorbidity, such as Type-2 diabetes, hypertension, or high cholesterol.
However, doctors are also reporting inquiries from individuals who do not meet the medical criteria.
“We are strictly discouraging its use for cosmetic purposes or in patients who do not meet the clinical threshold,” a Delhi-based doctor told Business Standard.
Sukhvinder Singh Saggu, director for minimal access, GI and bariatric surgery at the Delhi’s CK Birla Hospital, added that such requests for the prescription of GLP-1 RA from people who do not meet the criteria of BMI or the criteria of comorbid conditions are coming on a daily basis.
“This is happening as many are coming for aesthetic weight loss, seeing GLP-1 therapies as a quick slimming fix,” he added.
Health experts say that obesity is a complex, chronic disease and a major driver of non-communicable diseases such as cardiovascular diseases and type 2 diabetes and some types of cancer.
Doctors have also warned of common side effects of GLP-1 therapies, which include nausea, vomiting, diarrhea, bloating, not being able to eat much, low capacity, low motility and decreased gastric emptying.
“The less or rare side effects we can see are gallstone disease, pancreatitis and thyroid carcinoma, though they have not yet been reported, but definitely they are there,” Saggu said.
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