News
WHO backs GLP-1 therapies for obesity
Landmark new guidelines have endorsed Ozempic-like medicines as a long-term treatment of obesity in adults, alongside ‘intensive behavioural interventions’.
The World Health Organization has declared obesity ‘a major global health challenge’.
In a historic decision, the World Health Organization (WHO) has endorsed glucagon-like peptide-1 (GLP-1) therapies for the long-term treatment of obesity.
The landmark policy change was announced on Monday, with new guidance containing two key recommendations:
- GLP-1 therapies may be used by adults, but excluding pregnant women, for the long-term treatment of obesity
- Intensive behavioural interventions, including structured interventions involving healthy diet and physical activity, may be offered to adults living with obesity prescribed GLP-1 therapies.
The guideline specifically references liraglutide, semaglutide and tirzepatide – all of which are available for weight loss in Australia.
However, the WHO says while these medications represent the ‘first efficacious treatment option for adults with obesity’, it emphasises that medicines alone will not solve the problem.
‘Obesity is not only an individual concern but also a societal challenge that requires multisectoral action,’ it says.
The WHO is now calling for ‘urgent action’ on global manufacturing, affordability and system readiness to expand access to GLP-1 medications.
In its announcement, WHO said more than one billion people worldwide are affected by obesity, with that number projected to double by 2030 ‘without decisive action’.
Chair of RACGP Specific Interests Obesity Management, GP and dietitian Dr Terri-Lynne South told
newsGP the announcement ‘represents just how much these medications are taking the landscape by storm’, and also how quickly it is changing.
‘The interesting thing with the WHO is that this is conditional advice, because we still need further long-term information – they’re talking about relooking at this every six months, and I think that reflects on how quickly this space is moving,’ she said.
In 2022,
32% of Australian adults were living with obesity, as were 8.1% of children and adolescents.
In the same year, Australia ranked 10th out of 21 OECD countries for the proportion of people aged 15 and over who were living with overweight or obesity.
In a
newsGP poll conducted in May, 32% of GPs reported that patients asked them about weight loss medication daily, and 36% said weekly.
Dr South said she is pleased to see the WHO guidelines calling for governments to address the need to develop systems ‘to actually prevent people from developing obesity in the first instance’.
‘We need to be having government intervention for the health of the nation,’ she said.
‘It’s talking about environments, as well as policies that can enable improvements from a health and lifestyle point of view to call out the inequity in access to this medication.
‘Cost is the biggest inequity in the burden of obesity in Australia; the people who need the medication the most are the ones who can afford it the least, because there is a socio-economic disparity in the percentage of prevalence of obesity in Australia.’
Dr South also welcomed the WHO addressing obesity ‘as a chronic, long-term health concern that needs long-term management, and not just about weight loss’.
‘It’s also about being able to utilise these medications in amongst other grassroots interventions, including calling on improvements with regards to access inequity, but also environmental changes that support improvements for nutrition and metabolic health, independent of weight loss,’ she said.
The WHO announcement comes after the Therapeutic Goods Administration (TGA)
issued product alerts over several GLP-1 RAs on Monday, linking the medications to potential risks of suicidal thoughts and, for one drug, reduced efficacy of oral contraception.
At present, only Saxenda, Wegovy and Mounjaro have TGA approval for use in chronic weight management, but off-label use for several weight-loss medications continues to soar.
Dr South believes the TGA and WHO are ‘definitely aligned’ in their approach.
‘The WHO is more taking a global view of things, confirming that obesity should be looked at as a long-term chronic condition that is relapsing,’ she said.
‘But we do have relatively safe add-on obesity management medications. They reinforce that all intervention needs to start with a basis of lifestyle intervention tailored to the individual, looking at diet, exercise, behaviour management and to manage people’s comorbidities in parallel, that it’s not just about weight loss alone.’
WHO Director-General Dr Tedros Adhanom Ghebreyesus said the new guidelines recognise obesity as ‘a chronic disease that can be treated with comprehensive and lifelong care’.
‘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,’ he said.
The guidelines also address implementation concerns around increasing production and availability of the medications, and the need for countries to prepare health systems and policies accordingly.
‘Even with rapid expansion in production, GLP-1 therapies are projected to reach fewer than 10% of those who could benefit by 2030,’ said the organisation.
‘Without deliberate policies, access to these therapies could exacerbate existing health disparities. WHO calls for urgent action on manufacturing, affordability, and system readiness to meet global needs.’
Log in below to join the conversation.
chronic disease GLP-1 obesity Therapeutic Goods Administration weight loss weight management World Health Organization
newsGP weekly poll
Do you think GLP-1 RA medicines should be added to the PBS as a treatment for obesity?