New World Health Organization guidelines for GLP-1 weight-loss drugs state that “intensive behavioral therapy” should be combined with these revolutionizing medications for obesity treatment. In the guidance, released, Monday, the WHO called for a global “obesity ecosystem” to ensure the fair use of the drugs.
More than one billion people are affected by obesity worldwide, and in 2021 the disease was linked to some 3.7 million deaths from heart disease, diabetes and other conditions. Yet in recent years, GLP-1 drugs such as Novo Nordisk’s Ozempic and Wegovy—while expensive—have proven surprisingly effective in treating obesity, three WHO officials write in the organization’s guidance, which was published in JAMA. Those successes have raised hopes for treatment—and questions about fairness.
“The advent of these medicines represents a tipping point in the treatment of obesity, its complications, and related comorbidities,” the WHO officials write. In a pair of good-practice recommendations, they call for “long-term” use of the drugs and for the inclusion of diet and exercise counseling to treat obesity in adults. Ultimately, treating the condition effectively will require a “building a broader obesity ecosystem” to ensure no one is left behind, they write.
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According to the WHO’s best-case scenario, there is not enough GLP-1 to cover everyone with obesity: In the next few years, the WHO officials write in their paper, some 100 million people are expected to have access to the drugs—less than 10 percent of people with obesity. Still, the new drugs “could transform obesity into a treatable chronic condition,” the officials add.
The WHO guideline “signals that GLP-1s for obesity treatment are moving into the mainstream of health care,” says Louis Aronne of Weill Cornell Medicine, founder and past chair of the American Board of Obesity Medicine. It emphasizes early diagnosis and treatment, he notes, changing the landscape for managing metabolic diseases—for example, by sharply curtailing patient progression to diabetes with GLP-1 medications. “Think of the dramatic improvement in quality of life and reduced health care costs associated with that one outcome alone, yet treating obesity produces so many more benefits,” Aronne says.