Geneva – The World Health Institution on Monday issued its first-ever guidelines for the use of GLP-1 therapies-medications initially developed for diabetes-in treating obesity, a move reflecting the growing global recognition of obesity as a chronic health issue. While acknowledging potential benefits, the WHO’s recommendations come with caveats regarding cost, long-term data gaps, and equitable access, particularly as demand surges and impacts availability for those with diabetes. The guidance includes adding these therapies to the WHO’s Model List of Essential Medicines,a key step toward wider adoption by national health systems.
The World Health Organization (WHO) on Monday issued its first-ever guidance on therapies using glucagon-like peptide-1 (GLP-1), including medications like semaglutide, recommending their use for adults with obesity. The move signals a growing recognition of obesity as a chronic disease requiring comprehensive, long-term care, and advocates for equitable access to these treatments, even adding them to the WHO’s Model List of Essential Medicines.
The Model List, which currently includes 532 therapies, is considered by the organization to be indispensable for a basic and universal healthcare system. This guidance is intended to help national health systems develop policies to improve access to these medications, which have shown promise in managing both diabetes and obesity.
“Our new guidelines recognize that obesity is a chronic disease that can be treated with comprehensive care and over the life course,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, during a press conference announcing the new guidance. While acknowledging that medications alone won’t solve the global health crisis posed by obesity, Dr. Tedros emphasized that GLP-1 therapies “can help millions of people overcome obesity and reduce its adverse effects.”
The WHO’s approach emphasizes a holistic strategy built on three pillars: creating healthier environments through robust policies, protecting individuals at high risk through early detection and intervention, and ensuring access to person-centered, lifelong care for those living with obesity. This comprehensive approach highlights the complexity of addressing obesity and the need for multifaceted solutions.
GLP-1 therapies, including semaglutide, liraglutide, and dulaglutide, work by improving blood sugar control, suppressing appetite, and promoting weight loss. They are currently used to treat type 2 diabetes and obesity, and their emergence has been described as revolutionary in the way the disease is approached.
Obesity is a global pandemic, linked to 3.7 million deaths worldwide in 2024. Without effective interventions, the number of people living with obesity could double by 2030, underscoring the urgency of addressing this growing health challenge.
“Obesity is one of the most serious challenges of our time,” Dr. Tedros stated, adding that “these new medicines are a powerful clinical tool that offers hope to millions of people.”
The new WHO guidelines recommend the use of GLP-1 therapies for the long-term (over six months) treatment of obesity in adults, based on evidence of “moderate certainty,” with the exception of pregnant women. This recommendation reflects the growing body of evidence supporting the efficacy of these treatments.
However, the recommendation is conditional due to a lack of long-term data on their use, maintenance, and discontinuation, as well as current costs, inadequate preparation of health systems, and potential equity implications. These factors highlight the need for careful implementation and monitoring of these therapies.
In Portugal, these therapies are currently only covered by the National Health Service for patients with diabetes. Data from Infarmed, the Portuguese health authority, shows that antidiabetic drugs accounted for the largest expenditure for the SNS between January and September of this year, totaling €354.6 million. The increased demand for these medications, sometimes used off-label for weight loss, has led to shortages for diabetic patients.
In response, Infarmed announced in January a “broad” process of audits and inspections throughout the supply chain of certain diabetes medications to address the scarcity issues.
