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WHO Advisory on GLP-1 Drugs

Detailed Note on WHO Updates: Obesity Management, Weight Reduction, and Essential Medicines

The World Health Organization (WHO) has released a set of interconnected updates addressing the global health challenge of obesity, which affects over 1 billion people worldwide. These releases cover the use of new pharmaceutical treatments, comprehensive management strategies, and updated access to essential medicines.

1. WHO Global Guideline on GLP-1 Medicines for Treating Obesity (Dec 2025 Advisory)

Link to the Advisory :

https://www.who.int/news/item/01-12-2025-who-issues-global-guideline-on-the-use-of-glp-1-medicines-in-treating-obesity

This landmark release is WHO’s first guideline on the use of Glucagon-Like Peptide-1 (GLP-1) therapies for the long-term treatment of obesity, recognizing obesity as a chronic, relapsing disease.

  • Key Conditional Recommendations:
    • GLP-1 therapies (liraglutide, semaglutide, and tirzepatide) may be used for the long-term treatment of obesity in adults, with the exclusion of pregnant women.
    • The recommendation is conditional due to several factors, including:
      • Limited long-term data on efficacy, safety, and treatment maintenance/discontinuation.
      • High current costs and issues of access equity.
      • The need for adequate health system preparedness.
    • Intensive behavioral interventions (including healthy diet and regular physical activity) may be offered to adults prescribed GLP-1 therapies, based on evidence suggesting it may enhance treatment outcomes.
  • Emphasis on Comprehensive Strategy: The guideline strongly asserts that medication alone is insufficient to solve the global obesity crisis. It calls for a fundamental reorientation of approach built on three pillars:
    1. Creating Healthier Environments through robust population-level policies to promote health and prevent obesity.
    2. Protecting High-Risk Individuals through targeted screening and structured early interventions.
    3. Ensuring access to lifelong, person-centered care.
  • Access and Equity Concern: WHO emphasizes the need for urgent action to address the high costs and limited production of GLP-1 therapies. Without deliberate policies, such as pooled procurement or voluntary licensing, these treatments are projected to reach less than 10% of those who could benefit by 2030, potentially worsening health disparities.

2. WHO Guideline on Obesity Management (Detailed Framework)

Link to the Guideline :

https://app.magicapp.org/#/guideline/LrRxrL

The linked resource represents the broader, detailed framework from WHO for managing obesity. This guideline supports the comprehensive approach mentioned above by providing evidence-based strategies for clinical practice and public health. It covers:

  • Diagnosis and assessment of obesity (defined by WHO as BMI ≥ 30 kg/m²).
  • Non-pharmacological interventions, including structured programs for diet and physical activity.
  • The integration of pharmacotherapy (like GLP-1s) into a broader management plan.
  • The role of various health professionals in providing lifelong, person-centered care.

3. Updated List of Essential Medicines (EML) (Sept 2025 Advisory)

Link to the Advisory :

https://www.who.int/news/item/05-09-2025-who-updates-list-of-essential-medicines-to-include-key-cancer–diabetes-treatments

In a separate but related move, WHO updated its Model Lists of Essential Medicines (EML) and Essential Medicines for Children (EMLc). This update focused heavily on expanding access to critical treatments for cancer and diabetes, particularly those with associated comorbidities like obesity.

  • Inclusion of GLP-1 Receptor Agonists: Key medicines in this class were added to the EML:
    • Semaglutide, dulaglutide, and liraglutide (GLP-1 receptor agonists).
    • Tirzepatide (GLP-1/GIP dual receptor agonist).
  • Specific Indication: These therapies were added as a glucose-lowering treatment for adults with Type 2 diabetes mellitus who also have established cardiovascular disease or chronic kidney disease and obesity (BMI ≥ 30 kg/m²).
  • Rationale for EML Inclusion: By adding these high-impact medicines to the EML, WHO provides clear guidance to countries on which high-risk patients should be prioritized for access. The action aims to improve blood sugar control, support weight loss, and reduce the risk of heart and kidney complications in this vulnerable patient group, while also urging countries to find ways to make these high-cost drugs affordable.
  • Other Key Additions: The EML update also included seven new cancer medicines, notably the immune checkpoint inhibitor Pembrolizumab for certain metastatic cancers (cervical, colorectal, and non-small cell lung cancer), as well as treatments for cystic fibrosis, psoriasis, haemophilia, and blood-related disorders.

Conclusion

These three WHO releases collectively mark a significant policy shift, formally recognizing obesity as a serious chronic disease requiring long-term, multi-pronged management. They endorse the use of powerful new treatments (GLP-1s) for weight reduction and the management of high-risk diabetes/cardiovascular conditions while simultaneously calling on global leaders to urgently address the massive barriers of high cost and equitable access to ensure these life-changing medicines benefit all populations.

Key Takeaways

  • GLP-1 therapies mark a policy shift for obesity/diabetes management in high-risk groups, but require holistic strategies.​
  • Equity demands urgent affordability and manufacturing scale-up.​
  • Comprehensive care—medication, behavior, policy—essential; monitor evidence for updates.

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