The World Health Organization (WHO) has published a user guide on weight loss medications. It may seem a bit late, when drugs like Ozempic, Wegovy or Mounjaro have achieved enormous popularity, in many cases surpassing their availability. However, this guide is not as practical as practical instructions for the patient. It is reviewing available studies and concluding that there is sufficient evidence that the drug works without risks.
The body takes it a step further and includes it in its model list of essential medicines (there are currently 532) that it considers necessary to create a basic and comprehensive health system. This represents a formal position that helps health systems guide their public policies. In a world of 1,000 million people suffering from obesity, the World Health Organization calls for a global framework to determine who should receive GLP-1 first: without preventive policies, without equitable access, and without structural redesign of health systems, these drugs will not change the course of global obesity anyway. The World Health Organization claims that the health system must ensure that these treatments are “accessible to all” and also “accessible.”
“Our new guidelines recognize that obesity is a chronic disease that can be treated with comprehensive, lifelong care,” Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, said in the press release. “If good medicines alone will not solve this global health crisis, treatments with GLP-1 can help millions of people overcome obesity and reduce its harmful effects.”
Obesity is a global pandemic and will be linked to 3.7 million deaths worldwide by 2024. The advent of these drugs should represent a revolution in tackling this problem, a revolution that now has clear support from the World Health Organization. “This situation is very positive,” says Cristobal Morales, an endocrinologist at Vitas Hospital in Seville, who has been involved in decades of studies on these drugs. “The most important thing is to recognize that it is a complex disease that must be treated for life.”
Morales often quotes the famous line from Spider-Man: He considered these new drugs to be very powerful, but he regrets that not all patients bear responsibility at this level. “We are all aware of what is happening, the abuse that is happening, the black market and digital clinics that are spreading,” he says. “This encourages simple use over a short period of time, without supervision, and that is something we must combat.” This is also one of the organism observations, which shows that the drugs are effective when used long-term and under medical supervision.
In September 2025, the World Health Organization added GLP-1 therapies to the list of essential medicines for the management of type 2 diabetes in high-risk groups. “Today we are adding new recommendations that provide hope for millions of people,” Ghebreyesus said.
According to recent estimates, there are more than 1,000 million people in the world suffering from obesity, and this number is expected to double by 2030. But the use of slimming drugs can correct this trend. There is some macro data that points in this direction. The proportion of Americans with a BMI greater than 30 reached a maximum of 39.9% in 2022 and has now fallen to 37%, according to Gallup data. This is the first time in more than a decade that obesity rates have not increased in the United States. The survey also reveals that the number of people using GLP-1 or similar medications to lose weight has risen from 5.8% of the population in February 2024 to 12.4% today.
However, it is difficult to extrapolate data from the United States to the rest of the world. It is an obese, highly capitalist country: an enormous market for pharmaceutical companies. Various analyzes estimate that the US market will cover between 65 and 71% of GLP-1 drugs in 2024.
The WHO guidance emphasizes the importance of equitable access to GLP-1 therapies and preparing health systems to use them. “Our biggest concern is limited access, which could lead to a greater gap between the rich and the poor,” the organization’s Director-General explained. Therefore, he urges us to “take urgent action” to prevent this.
Semaglutide’s patent protection in China and India will expire in 2026. Companies in these countries are preparing to distribute drugs with similar functions to Ozempic at a lower price. On the other hand, the first pill treatments are expected to arrive in Europe, which are somewhat less effective, but much easier to manufacture (without the need to use needles), store and distribute (without the need for a cold chain). These two facts indicate a change in the market. But even with rapid production expansion, GLP-1 therapies are expected to reach less than 10% of those who could benefit from them by 2030.
In the current context, it seems clear that access to medicine will be conditional on money rather than need, which the WHO criticizes in its analysis. “How societies respond to this opportunity will determine whether this is truly the beginning of a new, more equitable era or a missed opportunity to record a historic success in global health,” he says.
Conditional recommendation
The WHO recommendations are classified as “conditional”, indicating that the desired consequences do not clearly outweigh the undesirable ones. This is the case for two reasons. First, there is a paucity of data on efficacy and safety over a long period of time, with several ongoing trials. Obesity is a chronic disease and should be treated with these medications as well. But the first GLP-1 agonists began to be marketed in the middle of a decade, and their use only became common two years ago. From forecasts, it is easy to conclude that nothing will happen in the long run, but in practice, in real cases, there is no data. Clinical trials and observational studies that follow patients receiving these treatments last between one and three years. “We have four years of data efficiently and safely,” Morales explains. He added: “Another important aspect of pharmacovigilance is that there are multiple studies in real life that reach full clinical studies. I believe that no drug has ever been studied like this.”
The second “button” on the body is due to evidence that behavioral therapy has improved the effectiveness of GLP-1 treatments. In this same article, the World Health Organization recommends combining medications with physical exercise, diet, counseling, and routine progress assessments. But he points out that there are few studies confirming its effectiveness. Nearly half of consumers gave up these medications within a year. In most cases, kilograms are lost.