GLP-1 based therapies and the future of obesity care
The rapid evolution of obesity medications, including GLP-1 receptor agonist (GLP-1 RA) therapies is reshaping the global conversation on obesity - bringing new opportunities alongside important policy, research and equity challenges.
In a new Comment published in The Lancet Global Health, authors from the World Obesity Federation and partners explore how these treatments are transforming obesity care, while outlining the steps needed to ensure they are used responsibly, equitably, and as part of a comprehensive approach to the disease.
A turning point for obesity treatment
For decades, rising obesity prevalence and its contribution to major causes of death and ill health were often confined to prevention discussions or overshadowed by stigma. The emergence of GLP-1 RA-based therapies - originally developed for diabetes and now increasingly used to treat obesity - marks a significant shift in this landscape.
READ THE COMMENTEvidence from over two decades of research shows these medications can lead to substantial and sustained weight loss, with additional metabolic and cardiovascular benefits. Their potential to reduce morbidity and mortality among millions of people living with obesity has been described as potentially transformative.
Recent global developments underscore this momentum, including World Health Organization recommendations for GLP-1 RAs in obesity care and their inclusion in the WHO Essential Medicines List for specific populations.
Prevention and treatment go hand in hand
The Comment emphasises that the growing role of pharmacotherapy should not be framed as an alternative to prevention. Instead, prevention and treatment are co-dependent and must be pursued together.
Primary prevention - addressing the drivers of unhealthy diets and physical inactivity - remains essential to reduce obesity risk. At the same time, treatment, including behavioural support and medical care, is critical for people living with obesity to manage the disease and reduce complications.
Behavioural interventions continue to play a key role alongside medication, supporting cardiometabolic health and helping minimise side effects.
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Key challenges: stigma, safety and access
Despite their promise, GLP-1 RAs raise important questions for health systems and policymakers.
Stigma continues to shape public perceptions, with obesity frequently framed as an individual responsibility and medications sometimes dismissed or trivialised. The authors highlight the need to reframe obesity as a chronic disease requiring evidence-based care.
As with any treatment, side effects such as gastrointestinal symptoms can occur, and further research is needed on long-term outcomes, optimal treatment duration, and use across diverse populations.
Equitable access is a major concern. High prices currently limit availability in many settings, particularly in low- and middle-income countries where obesity prevalence is rising fastest. Future generic and biosimilar options could help expand access, alongside policy measures to integrate these treatments into health systems.
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Building systems that can deliver care
The Comment highlights the need to strengthen health system capacity to safely and effectively provide obesity treatment. This includes improving training and awareness among healthcare professionals, integrating obesity care into primary health services, and embedding obesity education across medical curricula.
Greater public understanding is also needed to position GLP-1 therapies appropriately - as part of comprehensive care rather than standalone solutions.
Looking ahead
GLP-1 RA therapies represent a significant advance in obesity care, but their full potential will depend on how they are integrated into broader prevention, treatment and health system strategies.
The authors call for continued research, policy development and global collaboration to ensure these innovations translate into meaningful improvements in health outcomes - particularly for populations currently underserved by obesity care.
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