The World Health Organization (WHO) has released an evidence-informed guideline on the use of glucagon-like peptide-1 (GLP-1) therapies for the treatment of obesity among adults. The guideline was published in JAMA.
To develop inclusive, generalizable, and robust recommendations, WHO formed a multidisciplinary development group comprising experts in the fields of obesity, epidemiology, clinical management, pharmacology, health economics, public health programs, and policymaking. The development process followed WHO’s established standards, which endorse the GRADE methodology for evidence assessment.
Additional considerations included benefits vs harms, values and preferences of stakeholders, resource utilization and cost-effectiveness, health equity, acceptability, and feasibility.
Obesity as a Chronic Disease
Good Practice Statement
The guideline is based on the recognition of obesity as a chronic, relapsing disease that requires lifetime care. According to the panel, this lifetime care should include screening and early diagnosis and management of obesity-related complications and comorbidities with integrated approaches.
Of course, it helps to reduce weight — there is no question about it. But as physicians, it is important that they assess the full picture of obesity and not only the BMI.
In an exclusive interview with Endocrinology Advisor, Dr Luz Maria De Regil, director of the Department of Nutrition and Food Safety at WHO and co-author of the guideline, attributed this recognition to a reflection of the metabolic changes that occur over time in obesity.
“This guideline changes the conversation on understanding that [obesity] is a disease, not a risk factor,” she said. “Of course, it helps to reduce weight — there is no question about it. But as physicians, it is important that they assess the full picture of obesity and not only the BMI.”
According to moderate certainty evidence, the group issued a conditional recommendation that GLP-1 therapies may be used as long-term treatments for obesity.
“Obesity is not something that is just treated with GLP-1s — it’s actually a condition that needs to be treated throughout life to prevent relapses, manage early relapses, et cetera,” Dr De Regil said.
Behavioral Therapy
Good Practice Statement
The panel recommended context-appropriate counseling on behavioral and lifestyle changes as part of structured behavioral interventions for people living with obesity. Among those prescribed GLP-1 therapies or GLP-1/glucose-dependent insulinotropic polypeptide (GIP) dual agonists, this counseling should be the first step toward intensive behavioral therapy.
According to low certainty evidence, the group issued a conditional recommendation that intensive behavioral therapy may be provided as part of a comprehensive multimodal clinical algorithm among patients receiving GLP-1 therapies.
“[Treatment] not only depends on the medication — that’s the first part,” Dr De Regil said. “What we want is to establish long-term habits [and] use this opportunity as a means to reestablish or reset positive habits in terms of healthy dietary eating or physical activity.”
The panel concluded, “Though their contribution to establishing the conditions for change, the availability of GLP-1 therapies must also now galvanize the global health community to build the new ecosystem needed to offer fair, integrated, and sustainable solutions — embracing pharmacological innovation to deliver a wider and more holistic system transformation.”
References:
Celletti F, Farrar J, De Regil L. World Health Organization guideline on the use and indications of glucagon-like peptide-1 therapies for the treatment of obesity in adults. JAMA. Published online December 1, 2025. doi: 10.1001/jama.2025.24288
