What to Know About the WHO’s New GLP-1 Drug Guideline

• Global obesity prevalence has more than doubled between 1990 and 2022, underscoring obesity as a major and growing public health concern worldwide. In contrast, the United States has recently seen a modest decline in adult obesity rates, dropping from nearly 40% to approximately 37% by 2025. This shift has coincided with increased use of GLP-1 receptor agonists such as semaglutide and tirzepatide, which were approved for obesity treatment in recent years.
• In response to these trends, the World Health Organization released its first-ever guideline on the use of GLP-1 and dual GIP/GLP-1 receptor agonists for obesity treatment. A major component of this guidance is the WHO’s official recognition of obesity as a chronic, relapsing disease, similar to conditions like hypertension or diabetes. This reframes obesity away from being viewed as a personal failure and toward a condition requiring long-term medical management, with the goal of reducing stigma, promoting earlier diagnosis, and improving clinician and patient engagement.

WHO Recommendations 

• GLP-1 receptor agonists may be used for long-term obesity treatment in adults
  • Excludes pregnant patients
• Intensive behavioral interventions should be offered alongside GLP-1 therapy
• Recommendations are conditional due to:
  • Limited long-term safety data
  • Variable health system readiness worldwide
• WHO stresses that GLP-1 therapies are not a standalone solution. Instead, they should be used as part of a multimodal approach that includes behavioral counseling focused on diet, physical activity, and goal-setting, along with ongoing, long-term follow-up. 

How will it be implemented in family medicine? 

• In family medicine, implementing this guidance reinforces obesity as a chronic disease that requires ongoing management rather than short-term intervention.
  • GLP-1 therapy can be supported with careful patient selection and counseling, while highlighting the importance of shared decision-making, realistic expectations, and long-term follow-up plans. 
  • This approach encourages primary care clinicians to move beyond a “lifestyle-only” framework and adopt a more comprehensive, medical model of obesity care.
• Primary care clinicians are uniquely positioned to operationalize this guidance by identifying obesity early, screening for associated comorbidities such as type 2 diabetes, hypertension, dyslipidemia, obstructive sleep apnea, and NAFLD, and addressing obesity proactively during routine visits like annual exams or diabetes follow-ups.
• Framing GLP-1 therapies as legitimate medical treatments, similar to insulin or antihypertensives, helps normalize their use while emphasizing that they are not cures and may require long-term therapy.
• Shared decision-making remains essential, with discussions covering potential benefits, limitations such as cost and side effects, and the uncertainty surrounding long-term use. 
• Barrier: While the WHO strongly recommends pairing GLP-1 therapy with behavioral interventions, implementation in primary care can be challenging due to time constraints, limited access to dietitians, and reimbursement barriers. Even so, brief counseling and appropriate referrals can meaningfully improve outcomes.
• Ongoing monitoring and follow-up are critical, as discontinuation of GLP-1 therapy often leads to weight regain, reinforcing the need for long-term care plans and, in some cases, maintenance dosing. Finally, family medicine plays a key role in promoting equitable access, advocating for coverage, and preventing disparities, particularly as the WHO warns that global access to GLP-1 therapies may remain limited over the next decade.