WHO Endorses GLP-1 Drugs Like Semaglutide for Obesity, Highlighting Cardiac and Metabolic Benefits

Mumbai, Dec 6: The World Health Organization  has recently released a landmark guideline declaring obesity as a ‘chronic, relapsing disease’ that demands lifelong care, marking a definitive shift away from viewing it merely as a lifestyle condition. The guideline, published on Dec 1 in JAMA, validates the clinical efficacy of Glucagon-like peptide-1 (GLP-1) therapies, the class of medication that includes semaglutide, recommending them for long-term use in adults with obesity.

Obesity is relatively recent but growing global health problem, affecting more than 1 billion people worldwide. India too is facing an escalating obesity epidemic, with one in four adults currently affected and projections rising to one-third of the population by 2050. This crisis also exacts a staggering economic toll, with overweight and obesity costing the health system approximately $2.4 billion annually and reducing economic productivity by an estimated $28.9 billion (1% of GDP), underscoring the urgent need for holistic interventions. In this scenario, the new WHO guideline offers a comprehensive overview of obesity management. It emphasizes that medication is a critical tool that should be integrated into a person-centred care approach alongside behavioural, medical, surgical, and other interventions, and the prevention and management of comorbidities.

1. A shift to long-term medical management: The WHO recommends that GLP-1 therapies be used as a long-term treatment (6 months or longer) for adults living with obesity. This recommendation recognizes that obesity is a relapsing disease and that GLP-1 therapies provide clinically meaningful weight loss.

2.Health benefits beyond weight loss: The guideline highlights that the clinical potential of GLP-1 therapies has expanded significantly since their initial approval for diabetes in 2005. Therapeutic benefits extend to the following:

3. Maximizing results with behavioural support: To amplify and sustain these therapeutic benefits, the WHO recommends pairing pharmacotherapy with intensive behavioural therapy (IBT). This multi-modal approach includes structured goal setting for diet and physical activity, energy intake restriction, and frequent counselling sessions. Lifestyle counselling is recommended as a first step toward IBT for individuals prescribed GLP-1 therapies.

4. Addressing the access challenge: While the clinical effectiveness of these therapies is evident, the WHO has graded its recommendations as conditional. This rating reflects the urgent need to address real-world barriers, including high costs, the need for more long-term safety data, and the risk of unequal access across different health systems. With over 1 billion people affected by obesity, current production capacities cover only a small fraction of the need.

To navigate these challenges, the WHO outlines a strategic path forward by prioritizing high-risk patients. Because global access will take time, the immediate priority is creating a transparent framework to identify and treat those with the highest medical need first, expanding eligibility as capacity evolves. Secondly, the guideline points to strategies like tiered pricing and innovative formulations, such as oral GLP-1 therapies, to improve production and distribution logistics.

The release of these guidelines represents a tipping point in the treatment of obesity and its complications. The WHO emphasizes that the availability of effective therapies must galvanize the global community to build a fair, integrated, and sustainable obesity ecosystem. By shifting from reactive responses to anticipatory governance, nations have a historic opportunity to stall the epidemiological trajectory of obesity and ensure that comprehensive disease management is universally available, affordable, and sustainable for all who need it.