WHO releases its first-ever GLP-1 weight-loss drug guidelines

The WHO's first guidelines for using GLP-1 obesity drugs, published today in JAMA, signal a shift in the way the agency frames weight-loss treatment.

Developed by a committee of experts in obesity, pharmacology and public health, the agency's guidance endorses the long-term use of GLP-1 therapies, combined with intensive behavioral therapy, for adults with obesity to optimize and maintain health benefits.

The WHO defines "long-term" as six months or longer.

“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," WHO Director-General Dr. Tedros Adhanom Ghebreyesus said in a news release. "While medication alone won't solve this global health crisis, GLP-1 therapies can help millions overcome obesity and reduce its associated harms."

The guideline recommendations specifically apply to the three GLP-1 drugs approved by the FDA for weight loss in adults -- liraglutide, semaglutide and tirzepatide, the WHO says.

In earlier guidance, the U.N. agency placed greater emphasis on behavioral counseling, like exercise and healthy eating habits, over medical intervention.

In September, the organization added GLP-1 drugs as a treatment for diabetes to its list of essential medicines, but stopped short of including them for obesity care alone.

"[This] new guidance recognizes that obesity is a chronic disease that can be treated with comprehensive and lifelong care," Adhanom Ghebreyesus said.

The WHO recommends early diagnosis and coordinated, person-centered care that integrates behavioral, medical and surgical interventions, as well as prevention and comorbidity management.

The GLP-1 use and indications recommendations, prompted by WHO state members, come as more than 1 billion people worldwide live with obesity, with projections reaching 2 billion by 2030.

Although the WHO classifies the new guidelines as conditional, many countries look to its guidance when shaping national health policies.

Authors of the JAMA communication also highlight the need for more long-term data on the safety and efficacy of GLP-1s and lower drug pricing to broaden access.

In the U.S., blockbuster weight loss drugs like Novo Nordisk's Wegovy (semaglutide) and Eli Lilly's Zepbound (tirzepatide) can cost over $900 a month without insurance coverage.

GLP-1 drugmakers Novo and Lilly have recently gravitated toward short-term pricing solutions, including direct-to-consumer, self-pay models that drop prices as low as $299/mo.

Last month, the Trump administration struck a deal with the two companies to lower the cost of GLP-1 weight loss drugs for people who pay out of pocket on TrumpRx or are enrolled in Medicare or Medicaid.

Alivia Kaylor is a scientist and the senior site editor of Pharma Life Sciences.