WHO issues first ever global guideline on GLP-1 medicines for obesity under medical supervision

GENEVA--The World Health Organization (WHO) on Wednesday has issued its first global guideline on the use of Glucagon-Like Peptide-1 (GLP-1) therapies for the treatment of obesity, a chronic and relapsing disease that affects more than 1 billion people worldwide and is linked to an estimated 3.7 million deaths in 2024.

The new guideline provides conditional recommendations for the use of GLP-1 receptor agonists and GIP/GLP-1 dual agonists in adults living with obesity. WHO stresses that these medicines must be prescribed and monitored only by appropriately trained health professionals, within a structured chronic care model that includes ongoing lifestyle and behavioral support.

“Obesity is a major global health challenge that WHO is committed to addressing by supporting countries and people worldwide to control it, effectively and equitably. Our new guidance recognises that obesity is a chronic disease that can be treated with comprehensive and lifelong care,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “While medication alone will not solve this global health crisis, GLP-1 therapies can help millions overcome obesity and reduce its associated harms.”

Background to the guideline

In September 2025, WHO added GLP-1 therapies to its Essential Medicines List for managing type 2 diabetes in high-risk groups. The new guideline extends this work by outlining how these medicines may be used as part of a broader strategy to treat obesity, alongside healthy diets, regular physical activity, and structured behavioral interventions.

Obesity is a key driver of cardiovascular disease, type 2 diabetes and some cancers, and contributes to worse outcomes in infectious diseases. The global economic cost of obesity is projected to reach 3 trillion US dollars annually by 2030.

Who should receive GLP-1 therapy and who should provide it

The guideline issues two conditional recommendations:

• GLP-1 therapies may be used for the long term treatment of obesity in adults, excluding pregnant women, when clinically appropriate.
• Intensive behavioral interventions, including structured support on diet and physical activity, may be offered in combination with GLP-1 therapies to enhance treatment outcomes.

WHO emphasizes that:

• GLP-1 medicines should only be prescribed, initiated, and monitored by qualified health professionals familiar with obesity management and the potential benefits and risks of these agents.
• Treatment should be delivered within a chronic care model, supported by a capacitated health system with trained staff, clear referral pathways, monitoring and evaluation, reliable procurement and supply chains, and financial coverage.
• These medicines are not a stand-alone or “quick fix” solution; they must be combined with counseling on healthy eating, physical activity, and other lifestyle changes.

Role of intensive behavioral therapy

The guideline underscores that all people living with obesity should first receive context-appropriate counseling on lifestyle and behavioral changes. For adults who are prescribed GLP-1 therapies, intensive behavioral therapy may be provided as a co-intervention in a comprehensive clinical plan.

In the trials informing the guideline, intensive behavioral therapy included:

• Goal setting for diet and physical activity
• Energy intake restriction
• Regular counseling sessions
• Periodic assessment of progress

The critical outcomes used to inform the recommendations were weight change, quality of life, and adverse events. Data on major cardiovascular events and mortality remain limited, which is one reason why the recommendations are conditional and call for careful monitoring.

System readiness and equity

WHO stresses that GLP-1 therapies should be introduced only where health systems are prepared to deliver them safely and equitably. Countries and decision makers are urged to consider:

• Local evidence, including cost-effectiveness and budget impact
• Social and ethical implications, including equity of access
• Inclusion of GLP-1 therapy within universal health coverage and primary care benefit packages where adopted

Without deliberate policies, expanded access could increase health inequities, with medicines reaching only a small proportion of those in greatest need. Even with rapid production growth, GLP-1 therapies are projected to reach fewer than 10 percent of eligible people by 2030. WHO calls for measures such as pooled procurement, tiered pricing and voluntary licensing to improve affordability and access.

Medication alone will not reverse the obesity epidemic

While GLP-1 medicines represent an important therapeutic advance, WHO reiterates that medication alone will not reverse the global obesity epidemic. A comprehensive strategy is required, built on three pillars:

1. Creating healthier environments through strong population-level policies that promote health and prevent obesity
2. Protecting individuals at high risk through targeted screening and early interventions
3. Ensuring access to lifelong, person-centred care, including behavioral support and, where appropriate, pharmacological and surgical options

Next steps

The guideline is a key deliverable under WHO’s acceleration plan to stop obesity and was developed following extensive evidence review and consultation with a wide range of stakeholders, including people with lived experience of obesity. It will be updated as new data on safety, efficacy and implementation become available.

During 2026, WHO will work with partners to promote a transparent and equitable prioritization framework so that people with the highest need are reached first, and so that GLP-1 therapies, where used, are administered safely by qualified health professionals within robust, person-centred care systems.

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