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The World Health Organization (WHO) has issued its first global guideline on the use of glucagon‑like peptide‑1 (GLP‑1) medicines to treat obesity as a chronic, relapsing disease in adults (World Health Organization [WHO], 2025a). The guidance offers conditional recommendations rather than prescriptive rules and stresses that medicines alone will not reverse the obesity epidemic; person‑centred, lifelong care remains fundamental. Ongoing concerns include limited long‑term safety data, high treatment costs, constrained supply and the real risk that access to GLP‑1 medicines could widen existing health inequalities if policy makers do not act deliberately to protect equity (WHO, 2025a, 2025b).
Obesity is now recognised as a complex, chronic disease and a major driver of non‑communicable conditions such as cardiovascular disease, type 2 diabetes and several cancers (GBD Obesity Collaborators, 2024). It also worsens outcomes when people develop infectious diseases, as seen clearly during the COVID‑19 pandemic (Popkin et al., 2020). WHO estimates that more than one billion people worldwide are living with obesity and warns that, without effective action, this figure could roughly double by 2030, contributing to millions of avoidable deaths each year (WHO, 2022, 2025a).
The economic impact is substantial. Global costs linked to obesity and overweight, driven by increased healthcare use, disability and loss of productivity, are projected to reach around 3 trillion US dollars a year by 2030 (World Obesity Federation, 2023). By providing clearer guidance on when and how to use GLP‑1 medicines within comprehensive obesity care, WHO aims to help countries improve outcomes while using resources more wisely (WHO, 2025a).
The new guideline follows WHO’s earlier decision to add selected GLP‑1 agents to the Model List of Essential Medicines for managing type 2 diabetes in people at high cardiovascular risk (WHO, 2025b). It is the first time WHO has set out formal recommendations on using GLP‑1 medicines specifically for obesity. The document stresses that pharmacotherapy should sit alongside, not replace, healthy eating, regular physical activity and behavioural support (WHO, 2025a).
WHO makes two main conditional recommendations for adults living with obesity, excluding pregnant women. First, GLP‑1 medicines may be considered for long‑term treatment where clinical criteria are met, as trials have shown meaningful weight loss and improvements in cardiometabolic risk factors (Wilding et al., 2021). The recommendation is conditional because evidence on long‑term safety, weight‑maintenance, outcomes after stopping treatment, and real‑world use is still limited, and because of high costs, variable health‑system readiness and potential adverse effects on health equity (Drucker, 2022; WHO, 2025a).
Second, adults prescribed GLP‑1 treatment should, where possible, also be offered structured behavioural interventions that support changes in diet, physical activity and other lifestyle factors. Evidence of low to moderate certainty suggests that combining medicines with intensive behavioural support leads to greater and more sustained weight loss than pharmacotherapy alone (Rubino et al., 2022). WHO therefore positions GLP‑1 agents as one part of a broader, multidisciplinary obesity‑management pathway (WHO, 2025a).
Although GLP‑1 medicines represent the first highly effective pharmacological option for many adults with obesity, WHO is clear that they cannot, in isolation, solve the obesity crisis (WHO, 2025a). Obesity is described as both an individual medical condition and a societal problem shaped by food systems, the built environment, marketing, social norms and wider determinants of health (Swinburn et al., 2019).
The guideline calls for action on three fronts: creating healthier environments through population‑level policies that make healthy choices easier; identifying and supporting people at higher risk earlier in life; and providing person‑centred, lifelong care for those already living with obesity (WHO, 2025a). Within this model, GLP‑1 treatment is an adjunct to, not a substitute for, long‑term lifestyle support and broader public‑health measures.
From a health‑system perspective, WHO highlights equity, affordability and supply as major concerns (WHO, 2025a). Manufacturing capacity, pricing, procurement and workforce constraints mean that only a minority of eligible patients are likely to access GLP‑1 treatment in the near term, particularly in low‑ and middle‑income countries. Even with rapid scale‑up, current estimates suggest that fewer than one in ten people who could benefit from these medicines will receive them by 2030 (WHO, 2025a).
To avoid exacerbating global health inequalities, WHO urges governments, multilateral agencies and manufacturers to consider tiered pricing, pooled procurement mechanisms and voluntary licensing arrangements, building on approaches used successfully for HIV, tuberculosis and hepatitis C medicines (Moon et al., 2011). The organisation also stresses the need for investment in training, clinical pathways and monitoring so that, where GLP‑1 therapies are available, they are used safely and effectively in primary and specialist care (WHO, 2025a).
The guideline was produced in response to requests from WHO Member States for clear, evidence‑based advice on the role of GLP‑1 medicines in obesity management (WHO, 2025a). It follows WHO’s established methods, including systematic reviews of the literature, structured assessment of benefits and harms, consideration of resource use, feasibility and acceptability, and input from stakeholders and people with lived experience of obesity.
This document forms a core part of the WHO Acceleration Plan to Stop Obesity and is intended as a living guideline that will be updated as new evidence emerges (WHO, 2023). WHO plans further work in 2026 to develop a transparent prioritisation framework so that those with the greatest medical need are first in line for treatment where access is limited (WHO, 2025a).
In adults, WHO defines obesity as a body mass index (BMI) of 30 kg/m² or above (WHO, 2022). GLP‑1 receptor agonists mimic an incretin hormone that increases insulin secretion in a glucose‑dependent manner, slows gastric emptying, reduces appetite and leads to weight loss, while lowering blood glucose and reducing cardiovascular and renal risk in people with type 2 diabetes (Drucker, 2022). The guideline focuses on three agents used for long‑term weight management in adults: liraglutide, semaglutide and tirzepatide (WHO, 2025a).
At SheMed, we shares WHO’s view that obesity is a chronic, relapsing disease and a global epidemic that cannot be reduced to “poor willpower” or short‑term dieting. Our programme is designed around the same principles: tackling obesity with evidence‑based GLP‑1 treatment where clinically appropriate, alongside structured lifestyle support and long‑term follow‑up, rather than offering quick fixes or purely cosmetic weight‑loss solutions.
If you are living with obesity and considering GLP‑1 treatment, it is important to do so within a structured, medically supervised programme. At SheMed, UK‑regulated clinicians provide GLP‑1 therapy alongside tailored lifestyle support, regular monitoring and women‑centred care, in line with emerging WHO guidance on obesity management. To find out whether our programme is appropriate for you, visit shemed.co.uk to complete a brief medical questionnaire to see if you are eligible.
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Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., & Kushner, R. F. (2021). Once‑weekly semaglutide in adults with overweight or obesity. The New England Journal of Medicine, 384(11), 989–1002.
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