The World Health Organization (WHO) is preparing to officially endorse weight-loss medications for treating obesity in adults globally for the first time, according to internal documents reviewed by Reuters. This landmark decision represents a significant shift in the agency's approach to addressing the growing global obesity epidemic.
WHO's New Stance on Obesity Medications
The UN health agency is developing comprehensive recommendations for obesity prevention, care, and treatment across different age groups. The guidelines for adults, expected to be finalized by August or September 2024, will specifically address "how and when this class of medications may be integrated as one component of a chronic care model that includes both clinical and lifestyle interventions."
The drugs in question—GLP-1 receptor agonists such as Novo Nordisk's Wegovy (semaglutide) and Eli Lilly's Zepbound (tirzepatide)—mimic the activity of hormones that slow digestion and increase satiety. Clinical trials have demonstrated impressive efficacy, with patients losing 15-20% of their body weight depending on the specific medication.
Global Obesity Crisis and Treatment Access
The WHO's move comes amid alarming global obesity statistics. More than one billion people worldwide now live with obesity, with approximately 70% residing in low and middle-income countries (LMICs), according to World Bank estimates.
While these medications have been launched in the United States and other high-income nations like Germany and the United Kingdom, their high cost—often exceeding $1,000 per month—presents a significant barrier to access. Studies also indicate that patients may need to continue treatment indefinitely to maintain weight loss.
Dr. Francesco Branca, Director of the Department of Nutrition and Food Safety at WHO, has previously emphasized that "obesity is a chronic disease that requires long-term management, and these medications represent an important addition to our therapeutic arsenal when used appropriately."
Essential Medicines List Consideration
In a parallel development, WHO experts will meet next week to consider including GLP-1 receptor agonists in the agency's Essential Medicines List (EML) for both obesity and type 2 diabetes treatment. The EML catalogs drugs that should be available in all functioning health systems and has historically improved access to critical medications in resource-limited settings.
In 2023, the expert committee declined to add obesity drugs to the list, citing insufficient evidence on long-term clinical benefits. However, the new internal memo indicates that WHO now supports their inclusion, reflecting evolving evidence and changing perspectives on obesity treatment.
Addressing Cost and Access Challenges
The WHO acknowledges significant concerns regarding the cost of these medications and calls for longer-term studies on cost-effectiveness across all settings, particularly in LMICs. The agency suggests that "the same mechanisms that are used in large-scale medicine access programmes may need to be adopted," including tiered pricing models or pooled procurement strategies.
The memo also highlights potential relief on the horizon: semaglutide, the active ingredient in Wegovy, will come off patent in some markets next year. Several pharmaceutical companies are already planning to launch more affordable generic versions. Additionally, liraglutide, an older-generation GLP-1 agonist, is already available as a lower-cost generic drug in the United States and Europe.
Implications for Global Obesity Management
The WHO's endorsement could significantly influence national health policies and treatment guidelines worldwide, potentially expanding access to these medications in regions where obesity rates continue to rise but treatment options remain limited.
Health economists note that while the upfront costs of these medications are substantial, they may ultimately prove cost-effective by reducing the long-term burden of obesity-related conditions such as cardiovascular disease, type 2 diabetes, and certain cancers.
"This represents a pivotal moment in how we approach obesity globally," said a senior health policy expert familiar with the WHO deliberations. "The challenge now is ensuring equitable access to these treatments while continuing to emphasize prevention strategies and addressing the social determinants of obesity."
The WHO's forthcoming guidelines are expected to emphasize that medication should complement, not replace, lifestyle interventions including dietary changes, physical activity, and behavioral support. The agency is also developing separate recommendations for managing obesity in children and adolescents, where the evidence base for pharmacological interventions remains more limited.
