18 Dec
18Dec

Author:  Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (Public Health)

Introduction

The World Health Organisation (WHO) now recommends GLP-1 and GIP/GLP-1 medicines for the long-term management of obesity in adults. Released on December 1, 2025, the guideline recognises obesity as a chronic disease and supports the use of medications such as semaglutide and tirzepatide alongside lifestyle and behavioural interventions. 

This marks a significant shift in global obesity care, moving beyond short-term weight loss to comprehensive, sustained treatment.

What Is Obesity?

The World Health Organization (WHO) defines obesity as having a Body Mass Index (BMI) of 30 or more in adults.

 Obesity is no longer seen merely as a risk factor. It is recognised as a chronic disease that affects how the body regulates weight, appetite, and overall health. Globally, obesity affects over one billion people and increases the risk of non-communicable diseases such as type 2 diabetes, cardiovascular disease, stroke, and certain cancers. 

These conditions account for millions of deaths worldwide each year. In children and adolescents, obesity increases the likelihood of early-onset non-communicable diseases, with health consequences that often extend into adulthood.

What Are GLP-1 and GIP/GLP-1 Medicines?

GLP-1 receptor agonists are medications that mimic glucagon-like peptide-1, a hormone involved in appetite regulation, satiety, and blood sugar control.

Common examples include:

  • Liraglutide

  • Semaglutide

GIP/GLP-1 dual agonists act on both glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptors.

An example is:

  • Tirzepatide

These medicines were initially developed for the treatment of type 2 diabetes, but growing evidence shows that they also support meaningful and sustained weight loss.

Why Did WHO Make This Recommendation?

The WHO’s recommendation is based on the understanding that obesity is a chronic,  disease that requires long-term care, not short-term interventions.

Managing obesity effectively means addressing its medical, psychological, and social impacts, rather than focusing solely on weight reduction. Care must be integrated into routine clinical practice and reflect the lived experiences of people living with obesity, including stigma, access to care, and long-term adherence challenges.

What Does the New WHO Guideline Recommend?

The WHO issued conditional recommendations, based on moderate-quality evidence, with two key points:

  1. In adults living with obesity, GLP-1 receptor agonists or GIP/GLP-1 dual agonists may be used as long-term treatment for obesity.

  2. In adults prescribed these medicines, intensive behavioural therapy may be provided as a co-intervention, within a comprehensive, multimodal clinical care approach.

Do These Medicines Replace Lifestyle Changes?

No. The guideline clearly states that medications should not replace lifestyle and behavioural interventions. 

Instead, optimal obesity care combines:

  • Nutrition therapy

  • Physical activity

  • Behavioural support

  • Pharmacotherapy (Drugs)

  • Surgery, where appropriate

These components are expected to work together, not in isolation.

Why This Guideline Matters

This recommendation represents a shift toward evidence-based, compassionate care. It also signals to governments, insurers, and healthcare systems that obesity treatment deserves the same long-term investment and structure as other chronic diseases.

The Way Forward

To maximise the impact of this guideline, several steps are needed:

  • Structured dissemination of the recommendations to healthcare providers, policymakers, and the public

  • Strengthened health system capacity, particularly in low- and middle-income countries

  • Continued research to improve the quality of evidence

Conclusion

WHO’s recommendation of GLP-1 and GIP/GLP-1 medicines highlights the need to approach obesity as a long-term condition that requires person-centred, evidence-based care. Medicines may support treatment, but only when integrated into comprehensive and compassionate care.

Source

WHO issues global guideline on the use of GLP-1 medicines in treating obesity [Internet]. [cited 2025 Dec 18]. Available from: https://www.who.int/news/item/01-12-2025-who-issues-global-guideline-on-the-use-of-glp-1-medicines-in-treating-obesity

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