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By Doris Obinna
Obesity, long recognised as a growing global health threat, has reached a scale that health experts describe as unprecedented. More than one billion people worldwide are now living with the condition, which the World Health Organisation (WHO) classifies as a chronic, relapsing disease. In response to mounting pressure from governments and health professionals, WHO has released its first-ever guideline on the use of Glucagon-Like Peptide-1 (GLP-1) therapies medications seen as a breakthrough in obesity treatment.
The new guideline marks a turning point in how obesity is addressed at both medical and policy levels. Traditionally viewed as an issue tied to individual behaviour, obesity is increasingly understood as the result of a complicated interplay of genetics, environment, lifestyle patterns and socioeconomic forces.
According to experts, defined by a Body Mass Index of 30 or higher, the disease is characterised by abnormal fat accumulation that drives major health risks, including heart disease, diabetes and certain types of cancer. It also worsens outcomes for people with infectious diseases, making it one of the most pressing non-communicable health challenges.
Recent statistics highlight the severity of the crisis. In 2024, obesity was linked to 3.7 million deaths across the world. WHO warns that without urgent intervention, the global number of people living with obesity could double by 2030. The economic implications are just as alarming: by the end of the decade, the global cost of obesity is projected to reach a staggering US$3 trillion annually, driven largely by the burden of managing related diseases.
Against this backdrop, WHO’s new guideline introduces conditional recommendations for the use of GLP-1 therapies, which include medications such as liraglutide, semaglutide and tirzepatide. These therapies help regulate blood sugar, support weight loss and reduce risks associated with type 2 diabetes, heart disease and kidney complications. In September 2025, WHO added GLP-1 therapies to its essential medicines list for high-risk individuals with type 2 diabetes, further signalling the importance of these drugs in global health.
The conditional recommendations suggest that GLP-1 therapies may be considered for long-term treatment of obesity in adults, except pregnant women. While clinical evidence shows significant benefits in weight reduction and metabolic improvement, WHO cautions that data on long-term safety, maintenance after therapy, cost barriers and health-system readiness remain limited. The organisation emphasises that medication should not be stand-alone; rather, it must be part of a comprehensive approach that includes healthy diets, regular physical activity and continuous support from health professionals.
“Obesity is a major global health challenge that WHO is committed to addressing. Our new guidance recognises that obesity is a chronic disease that can be treated with comprehensive and lifelong care,” said the WHO Director-General, Dr Tedros Adhanom Ghebreyesus.
Contributing factors
Also, experts point to a complex mix of contributing factors behind rising obesity rates. While consuming more calories than are burned and lack of physical activity remain central causes, genetics, stress, sleep patterns, medications and socioeconomic conditions also play significant roles. Environmental factors such as widespread availability of processed food and limited access to safe recreational spaces have made obesity a societal issue rather than merely an individual one.
To strengthen treatment outcomes, WHO notes that intensive behavioural interventions can be offered alongside GLP-1 therapies. These structured programs focus on personalised diets, increased physical activity and long-term lifestyle changes. Preliminary evidence suggests that when medication and behavioural support are combined, patients achieve better and more sustainable results.
Still, WHO stresses that medicine alone will not resolve the global obesity epidemic. The organisation is calling for a fundamental shift toward a holistic strategy built on three core pillars. The first is creating healthier environments through strong population-level policies that promote nutritious eating and active living. The second focuses on protecting individuals at high risk of developing obesity through early screening and structured interventions. The third pillar emphasises ensuring access to lifelong, person-centred care for those living with obesity.
Global demand for GLP-1 therapies
A major concern raised by WHO is equity. With global demand for GLP-1 therapies skyrocketing, access remains uneven across regions and income groups. Without deliberate policies to expand availability, the gap between those who can afford treatment and those who cannot could widen dramatically. Even with increased manufacturing, GLP-1 therapies are projected to reach fewer than 10 per cent of the people who stand to benefit by 2030. To address this, WHO is urging countries to consider strategies such as pooled procurement, tiered pricing, voluntary licensing and investments in local production capacity.
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Another growing threat is the proliferation of falsified and substandard GLP-1 products, driven by global shortages and high demand. These unsafe alternatives pose serious risks to patients and undermine trust in legitimate treatments. WHO is calling for stronger regulation, controlled distribution, patient education and increased global cooperation to safeguard public health.
The development of the guideline followed extensive analysis of available scientific evidence and consultations with a wide range of stakeholders, including patients and advocacy groups. It forms part of WHO’s broader acceleration plan to tackle obesity and is designed to be updated as new evidence becomes available. In 2026, the organisation plans to work with member states to establish a transparent prioritisation framework to ensure that those with the greatest need receive treatment first.
Prevalence of overweight and obesity
The urgency of these measures is underscored by rapidly shifting global trends in overweight and obesity. In 2022, approximately 2.5 billion adults aged 18 and over were overweight, including more than 890 million living with obesity. This means that 43 per cent of adults worldwide were overweight, an increase from just 25 per cent in 1990. The proportion of adults classified as obese reached 16 per cent in 2022, more than doubling over the same period.
Children and adolescents have not been spared. An estimated 35 million children fewer than five were overweight in 2024, with rates rising fastest in low- and middle-income countries. In Africa, the number of overweight children under five has risen by more than 12 per cent since 2000. Among those aged 5 to 19, more than 390 million were overweight in 2022, a dramatic jump from 8 per cent in 1990 to 20 per cent in 2022. The increase has been nearly identical among boys and girls.
As WHO’s new guideline takes effect, the organisation hopes it will serve as a catalyst for countries to rethink how they address obesity. GLP-1 therapies, while promising, are only one part of a much larger and more urgent effort to reshape environments, strengthen health systems and ensure that every individual regardless of income or geography has access to lifelong support.
The message from global health experts is clear: the world is at a critical crossroads. With coordinated action, obesity can be prevented, treated and managed. Without it, the health, economic and societal consequences will only deepen in the years ahead.
Obesity does not occur in isolation
According to the Centers for Disease Control and Prevention (CDC), obesity does not occur in isolation and usually brings with itself a host of other complications: “In women of reproductive age, obesity can increase the risk of conditions like polycystic ovary syndrome (PCOS) and diabetes, hence, affecting fertility. PCOS, a common endocrine (hormonal) disorder among women of childbearing age is characterised by the presence of high male hormones called androgens, irregular menses (oligomenorrhea), dysfunctional ovaries, as well as the presence of cysts in one or both ovaries.
“About one in five women of reproductive age are believed to be afflicted with PCOS. Diabetes, on the other hand, is caused when a simple carbohydrate called glucose is not metabolised properly in the body. Women with a BMI that reads obese are more prone to developing PCOS and diabetes. Both conditions have a fundamental aspect in common-insulin resistance. PCOS, in fact, can be a precursor to type 2 diabetes for this reason. Type 2 diabetes is caused when the cells of the body are unable to utilise insulin, that is, enough insulin may be produced but it cannot break down glucose.
“This resistance to insulin shoots up the levels of androgens in women, wreaking havoc on the hormonal balance in women. Those people diagnosed with PCOS and diabetes who are not physically active, have poor dietary consumption, and lead a stressful life further risk their health.
“All activities in the human body can be found in a cascade; one associated with another. Due to the similar functions of the body that are affected by these conditions, it is no surprise that they have been found to have an impact on the fertility of women as well. Ovaries comprise ova or eggs; one is released each month during ovulation in a bid to be fertilised. In PCOS, ovaries may have single to multiple cysts, which cause the androgen levels to shoot up. This does not allow the menstrual cycle to occur as usual.
“Furthermore, it can lead to reduced quality of eggs and erratic ovulation, therefore, compromising on women’s ability to conceive naturally. It is known that women have a limited reproductive window between the start of their menses and its cessation. Diabetes can impact this duration by delaying menarche and hastening menopause – this decreases the window by 17 per cent. It also expedites ovarian ageing leading to deteriorated egg quality and hence, decreasing the chances of pregnancies and increasing the possibility of miscarriage and stillbirth.
“Diabetic women may observe oligomenorrhea and/or absent menstruation (secondary amenorrhea), affecting their ability to successfully conceive. These are all essential elements of what makes the female reproductive system functional, and hence, such aberrations impact their fertility. However, it must be noted that a couple’s infertility can be due to health conditions in both men and women.”
