World Health Organization Guideline on the Use and Indications of Glucagon-Like Peptide-1 Therapies for the Treatment of Obesity in Adults

Francesca Celletti, Jeremy Farrar, Luz De Regil

JAMA 2026;335;(5):434-438. doi:10.1001/jama.2025.24288

Abstract

Importance Obesity is a chronic, relapsing disease affecting over 1 billion people worldwide, driving substantial morbidity, mortality, and economic burden. Glucagon-like peptide-1 therapies (GLP-1 therapies) provide clinically meaningful weight loss and broad metabolic benefits. In response to Member State requests, the World Health Organization (WHO) has issued guidelines for adults living with obesity.

Observations The guidelines recognize obesity as a chronic, relapsing disease requiring lifelong care and emphasize early diagnosis and integrated, person-centered approaches combining behavioral, medical, surgical, and other interventions alongside prevention and management of comorbidities. WHO recommends long-term GLP-1 therapies combined with intensive behavioral therapy to maximize and sustain benefits. Both recommendations were graded conditional, reflecting that GLP-1 therapies—with or without behavioral therapy—are effective, but limited long-term data, cost, system readiness, equity, variability in patient priorities, and context-specific feasibility remain considerations. Implementation of these guidelines depends on equitable access to affordable therapies, health system preparedness, and most importantly assurance that care is person-centered, nondiscriminatory, and universally accessible. Given the time required to implement these measures, a priority is a transparent, equitable, evidence-based framework to identify those at highest need while allowing incremental expansion of eligibility as access, capacity, and readiness evolve; this will be the next focus of the WHO guideline.

Box.

World Health Organization Guideline on the Use and Indications of Glucagon-Like Peptide-1 (GLP-1) Therapies for the Treatment of Obesity in Adults

Good Practice Statement 1

Obesity is a chronic disease requiring lifetime care. This should include screening, early diagnosis and management of obesity-related complications and comorbidities, and consideration of pharmacological, surgical, or other treatments to manage the disease and prevent or treat comorbidities.

Recommendation 1

In adults living with obesity, GLP-1 therapies may be used as a long-term treatment for obesity. (conditional recommendation, moderate certainty evidence)

Good Practice Statement 2

People living with obesity should receive context-appropriate counseling on behavioral and lifestyle changes—including, but not limited to, physical activity and healthy dietary practices—as an initial step toward more structured behavioral interventions. For individuals who are prescribed GLP-1 receptor agonists or GLP-1/glucose-dependent insulinotropic polypeptide (GIP) dual agonists, counseling on behavioral and lifestyle changes should be provided as a first step to intensive behavioral therapy to amplify and support optimal health outcomes.

Recommendation 2

In adults living with obesity who are prescribed GLP-1 therapies, intensive behavioral therapy may be provided as part of a comprehensive multimodal clinical algorithm. (conditional recommendation, low certainty evidence)

Conclusions and Relevance Medication alone cannot solve the global obesity burden. The availability of GLP-1 therapies should galvanize the global community to build a fair, integrated, and sustainable obesity ecosystem. Countries must ensure equitable access not only to comprehensive disease management, but also to health promotion and prevention policies and interventions targeting the general population and those at high risk.