WHO Guidelines on GLP-1 Agonist Drugs

The World Health Organisation (WHO) has issued new guidelines on the use of glucagon-like peptide-1 (GLP-1) agonist drugs, emphasizing equitable access and healthcare system preparedness for their widespread use.

Background and Recommendations

• GLP-1 therapies, included in WHO’s Essential Medicines List for type 2 diabetes, are now recommended for long-term obesity treatment in adults, excluding pregnant women.
• The guidelines promote a comprehensive approach, including healthy diets, physical activity, and professional support for obesity management.

Key Considerations

• While effective for obesity treatment, the recommendations are conditional due to: 
  1. Limited long-term efficacy and safety data.
  2. High current costs.
  3. Inadequate health system readiness.
  4. Potential equity issues.
• Medicines alone are insufficient; a broader strategy is needed to address obesity, involving environmental policy changes and access to lifelong care.

Global Impact and Challenges

• Obesity affects over 1 billion people, causing 3.7 million deaths globally in 2024. Numbers could double by 2030 without decisive action.
• There is rising demand for GLP-1 drugs from non-eligible patients, leading to ethical concerns regarding their use for cosmetic weight loss.

Medical Criteria and Misuse

• Standard guidelines require a BMI over 27 with at least one obesity-related comorbidity for medication eligibility.
• Reports indicate misuse by individuals seeking aesthetic weight loss, which is discouraged by healthcare professionals.

Health Risks and Side Effects

• Common side effects include nausea, vomiting, diarrhea, and decreased gastric motility.
• Potential, though less common, risks include gallstone disease, pancreatitis, and thyroid carcinoma.