Why is it in News?
- On 1 December 2025, the World Health Organization (WHO) issued its first global guidelines on the use of GLP-1 (Glucagon-Like Peptide-1) weight-loss drugs for treating adult obesity.
- WHO formally recognised GLP-1 therapies as effective, but issued conditional recommendations due to limited long-term data, high costs, and global inequity in access.
- The decision has major implications for public health, global obesity economics, and equitable access to new metabolic drugs.
Relevance
GS-II: Health
- WHO’s first global obesity-drug guidelines; global obesity governance.
- Integration of pharmacotherapy with behavioural interventions.
GS-III: Science & Tech
- GLP-1 mechanism; metabolic diseases; long-term safety questions.
- Supply-demand imbalance; counterfeit risks.
GS-II: Equity & Public Policy
- High cost; insurance gaps; unequal access in LMICs.
- Role of generics, price caps, regulated distribution.
What Are GLP-1 Drugs?
- GLP-1 = Glucagon-Like Peptide-1, a hormone produced in the gut.
- Functions:
- Stimulates insulin secretion.
- Slows gastric emptying.
- Reduces appetite and cravings.
- Improves metabolic markers (glucose, lipids).
- Designed originally for type-2 diabetes → later found to cause significant weight loss.
Examples of GLP-1 Drugs
- Semaglutide (Ozempic, Wegovy)
- Liraglutide (Saxenda)
- Tirzepatide (Mounjaro; dual GLP-1/GIP agonist, highly effective)
Why GLP-1 Matters Globally
- Obesity ≠ lifestyle problem; it is a chronic metabolic disease.
- GLP-1 drugs represent the first major breakthrough since bariatric surgery.
Impact
- Weight loss: ~15–22% depending on drug.
- Reduced risk of:
- Type-2 diabetes
- Cardiovascular events
- Certain cancers
- Severe infectious disease outcomes
- Economic angle: Obesity may cost $3 trillion annually by 2030.
- GLP-1 drugs could reduce this burden if made accessible.
Key Elements of WHO’s New Guidelines
Conditional Recommendation
- Use GLP-1 drugs for adults with obesity, except pregnant women.
- Conditional because:
- Limited long-term safety data.
- Unknown effects after drug discontinuation.
- Extremely high cost and equity barriers.
Must Accompany Behavioural Interventions
- Drugs cannot be used alone.
- Diet modification + physical activity + counselling remain essential.
- GLP-1 → only when lifestyle interventions fail or when obesity is severe.
Equity as Central Principle
- WHO stresses:
- Tax-funded or insurance-backed programmes.
- Avoiding two-tier systems where only the rich can access treatments.
- Need for affordable generics in developing countries.
Why WHO Issued Guidelines Now ?
- Rapid worldwide adoption of drugs like Ozempic/Wegovy.
- Sharp rise of off-label use and medical tourism.
- Multiple countries witnessing shortages due to demand.
- Need for global standards on:
- Who should use the drugs.
- How to integrate them into national obesity programmes.
- Ensuring safe and monitored usage.
Concerns Acknowledged by WHO
High Cost
- GLP-1 drugs cost ₹20,000–₹30,000/month in India (imported brands).
- Remains unaffordable for most low-middle-income populations.
- Insurance coverage extremely limited.
Limited Long-Term Data
- Weight regain after stopping is common.
- Safety beyond 5–10 years still unclear.
- Issues of gastrointestinal side effects (nausea, vomiting, inflammation).
Supply-Demand Problems
- High demand has led to shortages even in countries like US & UK.
- Could divert supply away from diabetics who need them clinically.
India-Specific Issues
Cost Barrier
- Experts say affordability is the biggest obstacle.
- Need for:
- Generic manufacturing
- Government price caps
- Wider insurance coverage
Misuse Risks
- Rising trend of:
- Off-label use for cosmetic weight loss
- Unmonitored consumption
- Counterfeit injectables
Guidance by Indian Experts
- Anoop Mishra: Need insurance coverage + generics for real impact.
- V. Mohan: GLP-1 is not a magic injection; diet + exercise remain primary.
Why GLP-1 Is a Global Public Health Turning Point ?
- Obesity now affects 1 in 8 people worldwide.
- Conventional lifestyle treatment works only for 10–15% long-term.
- GLP-1 therapies offer:
- Clinically significant weight reduction
- Improvements in metabolic syndrome
- Reduced long-term healthcare expenditure
GLP-1 + Equity: Core Challenge
- Without systemic action:
- Rich countries and wealthy individuals dominate access.
- LMICs (like India) face supply and affordability barriers.
- WHO stresses that GLP-1 must not become a luxury therapy.
Policies Needed Globally
- Public insurance coverage
- Regulation of prices
- Support for local manufacturing
- Integration into national obesity guidelines
- Continued investment in prevention and lifestyle interventions
Conclusion
- WHO’s recognition is a major milestone in global obesity management.
- GLP-1 drugs are effective and transformative but:
- Not a standalone solution
- Not universally accessible
- Not yet proven long-term
- The guidelines emphasise:
- Safety
- Equity
- Integrated care
- For India and other LMICs, affordability and insurance coverage will determine real-world impact.
