The Role of GLP-1 Therapies in Treating Obesity: A Comprehensive Overview

The Role of GLP-1 Therapies in Treating Obesity: A Comprehensive Overview

By Dr.Kijakarn Junda, 2025

Introduction Obesity has become a global public health crisis, affecting over 1 billion people and driving significant morbidity, mortality, and economic burden (Celletti et al., 2025). The World Health Organization (WHO) has recognized obesity as a chronic, relapsing disease, emphasizing the need for lifelong care and integrated treatment strategies. Among the emerging solutions, glucagon-like peptide-1 (GLP-1) therapies have gained prominence due to their ability to promote weight loss and improve metabolic health.

This article explores the WHO’s 2025 guidelines on GLP-1 therapies, their implications, and the broader challenge of building an equitable obesity management ecosystem.

Understanding Obesity: A Chronic, Relapsing Disease Obesity is not merely a lifestyle issue but a complex disease arising from interactions between genetics, neurobiology, eating behaviors, and obesogenic environments—factors exacerbated by globalization and industrialized food systems (Celletti et al., 2025). Defined as a chronic condition, obesity is associated with 3.7 million deaths annually due to noncommunicable diseases, with global costs projected to reach US $3 trillion per year by 2030 (WHO, 2024). The WHO guidelines underscore that obesity requires early diagnosis and a multifaceted approach, combining behavioral, medical, surgical, and preventive strategies alongside comorbidities management.

GLP-1 Therapies: A Paradigm Shift in Obesity Treatment Originally developed for diabetes, GLP-1 therapies were repurposed for obesity due to their effects on appetite regulation, satiety, and gastric emptying. The FDA approved liraglutide 3.0 mg for chronic weight management in 2015, and since then, their clinical potential has expanded to include benefits for cardiovascular health, sleep apnea, and neurodegenerative diseases (Celletti et al., 2025). As of 2025, 12 GLP-1 therapies are approved, with over 40 agents in development, reflecting their growing role in obesity treatment.

Key Recommendations from the WHO Guidelines The WHO’s 2025 guidelines provide a strategic framework for integrating GLP-1 therapies into obesity care. The recommendations include:

1. Long-term GLP-1 therapies for adults with obesity (conditional recommendation, moderate certainty evidence). The guidelines endorse these therapies for continuous treatment of at least 6 months, acknowledging their effectiveness but noting limitations like cost and long-term safety data gaps (Celletti et al., 2025).
2. Pairing pharmacotherapy with intensive behavioral therapy (IBT) (conditional recommendation, low certainty evidence). IBT—including structured diet and exercise programs, counseling, and progress tracking—is recommended to enhance the benefits of GLP-1 therapies, though the evidence for this approach remains limited (Celletti et al., 2025).

Both recommendations are conditional, reflecting the need for further research and addressing challenges like health system readiness and equity. The guidelines also highlight the importance of person-centered care and nondiscriminatory access.

Challenges in Implementation: Access, Equity, and System Readiness Despite their promise, GLP-1 therapies face significant barriers. High costs, limited production capacity (currently sufficient for only 10% of those with obesity), and supply-chain constraints hinder universal access (WHO, 2025). The WHO is exploring solutions like generic production, pooled procurement, and prequalification to improve availability. Additionally, health systems must be prepared to integrate these therapies with primary care, workforce training, and digital tools to support adherence and monitoring.

Building an Integrated Obesity Management Ecosystem The WHO emphasizes that medication alone cannot address the obesity crisis. A comprehensive approach is needed, including:

• Prevention and health promotion policies targeting the general population and high-risk groups.
• Upstream solutions addressing social determinants of obesity, such as food systems, urban design, and economic inequities.
• Universal health coverage to ensure equitable access to therapies and care.
• Research and innovation to develop next-generation treatments that are feasible and affordable.

The WHO guidelines call for a global effort to establish a sustainable, equitable ecosystem that treats obesity as a chronic disease and bends its epidemiological trajectory.

Summary of Recent WHO Guidelines on GLP-1 RAs for Obesity (2025):

The World Health Organization (WHO) released an evidence-informed guideline in 2025 on the use of glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RAs) for treating obesity in nonpregnant adults. Key points include:

1. Recommendations:
   • GLP-1 RAs are recommended for long-term (≥6 months) weight management in adults with obesity (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m² with weight-related comorbidities).
   • Pharmacotherapy should be paired with intensive behavioral therapy (IBT), including weekly counseling and routine progress assessments.
2. Evidence Base:
   • The guideline considers GLP-1 RAs as a class, drawing from systematic reviews of liraglutide, semaglutide, and tirzepatide. It emphasizes cost-effectiveness and global applicability.
3. Context:
   • Part of WHO’s response to the obesity crisis, aligning with the 2025 fact sheet on obesity and overweight.

Conclusion: A Call for Collective Action The WHO’s 2025 guidelines mark a pivotal step toward modernizing obesity treatment. However, realizing their potential requires addressing access, equity, and systemic barriers. By integrating GLP-1 therapies into broader prevention and care strategies, societies can transform obesity management and mitigate its global health impact. The journey ahead demands collaboration, innovation, and a commitment to health for all.

References

1. Celletti, F., Farrar, J., & De Regil, L. (2025). World Health Organization Guideline on the Use and Indications of Glucagon-Like Peptide-1 Therapies for the Treatment of Obesity in Adults.
2. WHO. (2024). Obesity and overweight fact sheet.
3. WHO. (2025). GLP-1 therapies and global access challenges.
4. WHO Model List of Essential Medicines (2025). Inclusion of GLP-1 therapies for high-risk obesity populations.