The World Health Organization (WHO) has issued its first clinical guideline on the pharmacological treatment of obesity in adults, recommending the long-term use of GLP-1–based medicines for people living with obesity when clinically appropriate.
The guideline, published as a Special Communication in JAMA on 1 December 2025, endorses GLP-1 receptor agonists and GLP-1/GIP dual agonists – including agents such as liraglutide, semaglutide and tirzepatide – as options for ongoing obesity treatment in non-pregnant adults.
WHO states that, in adults living with obesity, GLP-1 therapies may be used as a long-term treatment for obesity, defining long-term as continuous use for six months or more in line with current regulatory definitions.
Although the recommendation is graded as conditional, it represents the first time WHO has formally endorsed this class of drugs for obesity management, rather than solely for type 2 diabetes or cardiovascular risk reduction.
What WHO recommends
According to the JAMA-published guideline, WHO advises that:
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GLP-1–based therapies may be used as long-term pharmacological treatment for obesity in non-pregnant adults.
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These medicines should only be used as part of a broader, multimodal care plan that includes behavioural support, structured nutrition guidance, physical activity goals and regular follow-up.
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Medication alone is insufficient; obesity management must combine pharmacotherapy with lifestyle and clinical support.
The conditional grading reflects uncertainties around long-term safety data, durability of weight loss after discontinuation, cost, system readiness and global access challenges.
Evidence behind the endorsement
WHO’s guideline development group used the GRADE framework and drew on systematic reviews of the most extensively studied agents in this class: liraglutide, semaglutide and tirzepatide. The evidence base demonstrates clinically meaningful weight reduction and metabolic improvements, though data gaps remain around optimal maintenance strategies and long-term outcomes in diverse populations.
Access and equity remain major concerns
WHO stresses that limited supply, high costs and uneven health-system capacity mean that access to GLP-1 medicines will remain restricted globally. The organisation warns that, even with production expansion, only a fraction of eligible individuals are likely to receive treatment by 2030.
The guideline urges governments and manufacturers to improve affordability, expand manufacturing and strengthen health-system infrastructure to support safe prescribing and long-term monitoring.
