The World Health Organization (WHO) has, for the first time, issued official recommendations on the use of drugs that mimic glucagon-like peptide-1 (GLP-1) for weight loss. However, it remains unclear how this will affect their prescription and cost.

Main WHO Recommendations

On December 1, WHO published two recommendations regarding the use of GLP-1 drugs, such as Wegovy (semaglutide) and Mounjaro (tirzepatide), for long-term obesity treatment. The organization advises that these medications should be used alongside other strategies, including counseling and regular medical monitoring of patients.

Recommendation #1

Adults with obesity are advised to undergo long-term therapy with GLP-1 medications to manage their weight. This conditional recommendation is based on moderate-certainty evidence supporting the effectiveness of these drugs in achieving clinically significant weight loss and improving metabolic indicators. Factors such as cost, healthcare system readiness, and equity of access are also considered.

Recommendation #2

Patients taking GLP-1 drugs benefit additionally from structured behavioral therapy. This includes setting goals for physical activity and nutrition, calorie restriction, regular counseling, and ongoing progress assessment. This recommendation is based on low-certainty evidence suggesting that intensive behavioral therapy enhances the effectiveness of GLP-1 medications, such as tirzepatide, semaglutide, and liraglutide.

Key Expert Comments

Professor Elaine Rush from Auckland University of Technology noted that the guidelines highlight the problem of obesity and the need for further research on these drugs. She emphasized the high cost of GLP-1 medications and recommended combining drug therapy with intensive behavioral interventions and regular counseling. The economic efficiency of such approaches has yet to be determined.

WHO also stressed that GLP-1 drugs should be accessible to people with obesity, but they are not a universal solution for individual patients or the global health crisis.

Obesity as a Global Challenge

Professor Peter Shepherd from the University of Auckland pointed out that over the past century, the main health threat has shifted from undernutrition to excess weight. Obesity has become a key factor in the development of cardiovascular and kidney diseases, type 2 diabetes, and certain cancers, all of which reduce life expectancy and quality of life. Previously, a major barrier to effective obesity treatment was a limited understanding of the biology of appetite and fat accumulation. Now, it is known that drugs mimicking the GLP-1 hormone (such as Wegovy and Ozempic) can safely and effectively reduce appetite and weight.

Issues of Accessibility and Long-Term Effects

Shepherd noted that the high cost of these drugs remains a significant barrier and exacerbates inequalities in access to treatment worldwide. Despite potential savings on food expenses during therapy, these medications are still unaffordable for many. However, it is expected that prices will decrease as patents expire and competitors enter the market.

Another concern is the lack of long-term studies on possible health complications due to the rapid spread of these drugs. This week, the Australian Therapeutic Goods Administration (TGA) issued a warning about the risk of suicidal thoughts and behaviors associated with GLP-1 medications.

Recent studies have shown that while patients lost weight and improved health markers during 36 weeks of tirzepatide (Mounjaro) therapy, some of the lost weight returned after stopping the medication—on average, 25% within a year of discontinuation.

Safety and Prevention Considerations

Shepherd emphasized that potential long-term side effects, such as loss of muscle mass—especially in older adults—require careful monitoring. Nevertheless, the demand for GLP-1 drugs has already led to the first recorded decrease in obesity rates in the United States, highlighting the real need for effective solutions. This also reflects the recognition of drug therapy as an important tool in the global fight against obesity.

Professor Rush added that more attention should be given to preventing the obesity epidemic, especially considering that many of the benefits of GLP-1 drugs may disappear after stopping treatment. She noted that for most people, obesity is linked to environmental factors: poor nutrition, lack of physical activity, poverty, and pollution, which are passed down through generations. Instead of long-term investments in these drugs, she believes resources should be directed toward reducing child poverty and improving school nutrition to ensure a better future and greater long-term returns.

The study was published in the journal JAMA.