The World Health Organisation (WHO) has issued its first-ever global guidelines on the use of GLP-1 (Glucagon-Like Peptide-1) receptor agonists for treating obesity, marking a major shift in international clinical and public-health policy. These medicines—originally developed for diabetes—have shown significant weight-loss benefits but raise concerns regarding affordability, long-term safety, and unequal access.
GLP-1 drugs mimic the natural hormone that increases insulin secretion, suppresses appetite, slows gastric emptying, and reduces glucagon levels. Popular therapies include liraglutide, semaglutide, and tirzepatide.
Key Features of the WHO Guidelines
1. Conditional Recommendations
WHO issued two conditional guidelines owing to limited long-term evidence and substantial cost barriers:
- GLP-1 Therapies for Adults: Medicines such as semaglutide and tirzepatide may be used for long-term treatment, except in pregnant women.
- Behavioural Interventions Mandatory: Drug therapy must be accompanied by structured dietary counselling, physical activity programmes, and regular follow-up.
2. Obesity as a Chronic Disease
The guidelines adopt a lifelong care model, positioning obesity as a chronic metabolic condition requiring sustained clinical management rather than short-term weight-loss attempts.
3. Three-Pillar Strategy
WHO recommends a multilevel approach that integrates:
- Population-level measures (healthy food policies, regulation of marketing, active-living environments)
- Targeted screening and early interventions
- Lifelong, person-centred care, including pharmacotherapy where appropriate
4. Health Equity Concerns
The guidelines highlight the limited global capacity to manufacture GLP-1 drugs and project that less than 10% of people with obesity worldwide will benefit by 2030 due to cost and supply constraints.
Global and Indian Burden of Obesity
Obesity is defined by WHO as BMI ≥ 30 in adults.
- Global Burden (2024): Over 1 billion people affected; 3.7 million deaths linked to obesity-related conditions.
- India (NFHS-5): 24% of women and 25% of men are overweight or obese.
- Projections: India may exceed 163 million adults with obesity by 2030, nearly doubling current levels.
Obesity’s rapid rise, combined with the expanding but inequitable availability of GLP-1 therapies, underscores the need for integrated public-health measures and affordable access strategies.
