The World Health Organization (WHO) has published its first global guidelines on the use of GLP-1 receptor agonist therapies for the treatment of obesity in adults, The move marks a profound change in the way this condition is addressed at the international level.
The institution formally recognises obesity as a chronic, progressive and relapsing disease, which already affects more than one billion people worldwide and whose prevalence could double in the coming years if strong action is not taken. The economic cost associated with this epidemic, including healthcare costs and lost productivity, could reach around $3 trillion per year by 2030.
The new document emphasises that medication alone, while effective, will not solve the problem. The WHO stresses the need for a comprehensive approach combining drugs, behavioural changes and broader social transformations. On the one hand, GLP-1 treatments are recommended for adults with obesity (excluding pregnant women) as part of a long-term management plan. On the other hand, it is emphasised that these medications should be accompanied by intensive lifestyle interventions, such as the adoption of balanced eating patterns, progressive increases in physical activity and structured follow-up by health professionals. These recommendations respond to the evidence that healthy habits enhance the efficacy of the drugs and promote sustainable results over time.
The WHO recalls that improving the social and community environment is as important as individual treatment. It calls for strong population policies that promote healthier environments, facilitate regular exercise and reduce exposure to ultra-processed and low nutritional quality foods. In addition, it highlights the importance of identifying those most at risk through early screening and providing structured interventions before the disease progresses.
In relation to available medicines, the guideline includes three agents for long-term treatment: liraglutide, semaglutide and tirzepatide. These drugs have been shown to reduce body weight, improve metabolic markers and reduce the risk of cardiovascular and renal complications, especially in people with type 2 diabetes. However, the WHO stresses that there is still limited evidence on their long-term safety and efficacy, so recommendations are conditional and require clinically supervised use.
Another major challenge identified by the WHO is unequal access to these therapies. Even with a substantial increase in production, it is estimated that less than 10 % of those who could benefit will have access to these medicines by 2030. This could widen the existing gap between countries with greater resources and those with weaker health systems. The institution also warns about the proliferation of counterfeit products or products of dubious quality, a phenomenon that requires strict regulation and robust pharmacovigilance mechanisms.
The recognition of obesity as a chronic disease and the incorporation of pharmacological therapies as part of its management represent a significant milestone. However, the success of this approach will depend on its integration with broader structural changes. The WHO calls on governments, health professionals, industry and civil society to make a coordinated commitment to transform this global health crisis into an opportunity to improve the health and quality of life of millions of people.
