JAMAWeight LossDecember 1, 2025

World Health Organization Guideline on the Use and Indications of Glucagon-Like Peptide-1 Therapies for the Treatment of Obesity in Adults.

Celletti F, Farrar J, De Regil L

View on PubMed DOI: 10.1001/jama.2025.24288

Key Finding

The WHO has issued its first-ever global guidelines recommending GLP-1 therapies combined with intensive behavioral therapy for treating obesity, recognizing it as a chronic disease affecting over 1 billion people worldwide.

What This Study Found

Think of obesity like a chronic condition that needs lifelong management - similar to how we treat diabetes or high blood pressure. The World Health Organization has now officially recognized this reality and issued global guidelines for GLP-1 medications (like semaglutide and tirzepatide) that work like having a personal appetite coach, helping people feel full longer and eat less naturally. The WHO's recommendations are like a roadmap with two main routes: use GLP-1 therapies for long-term treatment, and combine them with intensive behavioral therapy (think personal training for eating habits) to maximize results. However, both recommendations come with a 'conditional' grade - imagine this as the WHO saying 'these medications work well, but we need to be thoughtful about who gets them first.' The guidelines acknowledge that while these drugs are effective, there are real-world challenges like cost (these medications can cost $1,000+ per month), limited long-term safety data, and questions about which patients should be prioritized when access is limited.

Statistics Decoded

The abstract mentions over 1 billion people affected by obesity worldwide - that's roughly 1 in 8 people on Earth. The 'conditional' grading for both WHO recommendations means the evidence shows these treatments work, but factors like cost, equity, and long-term data create uncertainty about broad implementation. No specific weight loss percentages or clinical trial statistics are provided in this abstract, as this is a guideline paper rather than a clinical study.

Why This Matters

This marks the first time the WHO has issued global guidelines specifically for GLP-1 obesity treatments, giving these medications official international recognition and potentially influencing healthcare policies worldwide. The guidelines could help standardize obesity care globally while highlighting the urgent need for equitable access frameworks to prevent these breakthrough treatments from widening health disparities.

Original Abstract

Obesity is a chronic, relapsing disease affecting over 1 billion people worldwide, driving substantial morbidity, mortality, and economic burden. Glucagon-like peptide-1 therapies (GLP-1 therapies) provide clinically meaningful weight loss and broad metabolic benefits. In response to Member State requests, the World Health Organization (WHO) has issued guidelines for adults living with obesity. The guidelines recognize obesity as a chronic, relapsing disease requiring lifelong care and emphasize early diagnosis and integrated, person-centered approaches combining behavioral, medical, surgical, and other interventions alongside prevention and management of comorbidities. WHO recommends long-term GLP-1 therapies combined with intensive behavioral therapy to maximize and sustain benefits. Both recommendations were graded conditional, reflecting that GLP-1 therapies-with or without behavioral therapy-are effective, but limited long-term data, cost, system readiness, equity, variability in patient priorities, and context-specific feasibility remain considerations. Implementation of these guidelines depends on equitable access to affordable therapies, health system preparedness, and most importantly assurance that care is person-centered, nondiscriminatory, and universally accessible. Given the time required to implement these measures, a priority is a transparent, equitable, evidence-based framework to identify those at highest need while allowing incremental expansion of eligibility as access, capacity, and readiness evolve; this will be the next focus of the WHO guideline. Medication alone cannot solve the global obesity burden. The availability of GLP-1 therapies should galvanize the global community to build a fair, integrated, and sustainable obesity ecosystem. Countries must ensure equitable access not only to comprehensive disease management, but also to health promotion and prevention policies and interventions targeting the general population and those at high risk.