December 1, 2025

expert reaction to new WHO guideline for GLP-1 medications

Scientists comment on new WHO guidelines for GLP-1 medications for the treatment of obesity, published by JAMA.

Dr Marie Spreckley, research programme manager and researcher specialising in weight management research and clinical practice, Prevention of Diabetes and Related Metabolic Disorders in High Risk Groups, MRC Epidemiology Unit, University of Cambridge, said:

“This WHO guideline is an important and carefully balanced statement on the role of GLP-1 therapies in obesity care.  It clearly recognises obesity as a chronic, progressive, and relapsing disease that requires long-term, integrated management rather than short-term treatment.  The recommendations are appropriately graded as conditional, reflecting both the strong evidence for weight loss and metabolic benefit, and the remaining uncertainties around long-term use for obesity at higher doses, lifelong treatment, affordability, and health system capacity.  A key strength is the emphasis on combining medication with behavioural support and on the need for equitable access, rather than presenting drugs as a stand-alone solution.  The paper also avoids overspeculation by explicitly acknowledging supply constraints and the ethical and practical challenges of prioritisation.”

Prof John Wilding, Professor of Medicine & Honorary Consultant Physician, Department of Cardiovascular and Metabolic Medicine, University of Liverpool, said:

“I think this guideline from WHO should be broadly welcomed.  It reasserts the view that obesity is a chronic, relapsing disease that may require treatment, but also makes the important point that any strategy to curb the global obesity epidemic will require co-ordinated efforts in public health to look at food systems and the physical activity environment as well as improving access to treatment.  The main focus of the paper is on the incretin-based therapies (GLP1 agonists and GLP1/GIP agonists such as semaglutide and tirzepatide) that have been shown in clinical trials to help people living with obesity lose weight and improve their health, including benefits on complications such as diabetes, cardiovascular disease, sleep apnoea and arthritis.  It recognises that treatment needs to be used as a long-term treatment as is appropriate to manage the chronic, relapsing disease of obesity and that it should be supported by appropriate behavioural lifestyle treatment.  I hope this will help focus WHO member states to consider how to improve access to comprehensive obesity care, and this is a welcome first step.”

‘World Health Organization Guideline on the Use and Indications of Glucagon-Like Peptide-1 Therapies for the Treatment of Obesity in Adults’ by Francesca Celletti et al. was published in JAMA at 13:45 UK time on Monday 1 December 2025. 

DOI: 10.1001/jama.2025.24288

Declared interests

Dr Marie Spreckley: “I am an obesity researcher and registered public health nutritionist.  I am the named holder and principal investigator of a University of Cambridge Public Engagement Starter Fund award for the AMPLIFY project.  I also work on research programmes funded by the National Institute for Health and Care Research (NIHR).  I have no personal financial links to manufacturers of GLP-1 therapies and have not received any industry funding.”

Prof John Wilding: “John Wilding reports consultancy / advisory board work for the pharmaceutical industry contracted via the University of Liverpool in the last 36 months (no personal payment) for Alnylam, Amgen, AstraZeneca, Boehringer Ingelheim, Cytoki, Kailera, Lilly, Menarini, Metsera, Napp, Novo Nordisk, Pfizer, Prosciento, Response Pharmaceuticals, Rhythm Pharmaceuticals, Saniona, Shionogi and  Ysopia;  funding for clinical trials from Amgen, AstraZeneca and Novo Nordisk and personal honoraria / lecture fees from AstraZeneca, Boehringer Ingelheim, Medscape, Novo Nordisk and Menarini.

He is past president of the World Obesity Federation, a member of the Association for the Study of Obesity, Diabetes UK, EASD, ADA, Society for Endocrinology and the Rank Prize Funds Nutrition Committee. From 2009-2024 he was national lead for the Metabolic and Endocrine Speciality Group of the UK NIHR Clinical Research Network.”