Obesity has become a growing global concern, with rates rising rapidly in both high- and low-income countries. According to the World Health Organization (WHO), over 1 billion people worldwide are currently obese or overweight, contributing to millions of preventable deaths every year. Hence, as a measure, the WHO is set to recommend weight-loss drugs as a treatment for obesity in adults, according to draft guidelines published online.
WHO’s expert committee has concluded that GLP-1 receptor agonist drugs like Wegovy, Ozempic, and Mounjaro, can be part of long-term treatment for adults with a body mass index (BMI) of 30 or higher. The guidelines also stress combining these drugs with lifestyle changes and counseling for the best results.
The draft guidance, open for consultation until September 27, marks the first time WHO has formally recommended these drugs for obesity. It also calls obesity a ‘chronic, progressive and relapsing disease’ that affects over one billion people worldwide, contributing to millions of preventable deaths. WHO is also preparing separate guidelines for children and teenagers.
Why this matters
Obesity has often been seen as a matter of willpower or lifestyle choices. WHO’s draft guidelines challenge that view, showing that obesity is a medical condition that requires treatment.
The recommendation comes as GLP-1 drugs gain popularity for helping people lose weight safely. In countries like the United States, they are sometimes prescribed to people with a BMI between 27 and 30 if they have weight-related health conditions such as high blood pressure or diabetes.
However, WHO has not yet added these drugs to its essential medicines list for obesity treatment. The medicines are included for patients with type 2 diabetes, the disease they were originally made to treat. WHO noted that high prices make the drugs hard to access in low- and middle-income countries.
What are these drugs?
Wegovy
Wegovy is a weekly injectable medication that contains semaglutide, a GLP-1 receptor agonist. It is approved by the U.S. Food and Drug Administration (FDA) for adults with a BMI of 30 or higher (obese), or adults with a BMI of 27 or higher (overweight) who also have at least one weight-related medical condition such as high blood pressure, type 2 diabetes, or high cholesterol. Dosages start at 0.25 mg per week and gradually increase to 2.4 mg per week.
Clinical trials have shown Wegovy can help patients lose 15–20 per cent of their body weight over 68 weeks, significantly more than typical lifestyle interventions alone. A 2021 study published in the New England Journal of Medicine found that 69 per cent of participants taking semaglutide achieved at least a 10 per cent weight loss, compared with only 12 per cent in the placebo group. The drug works by activating GLP-1 receptors in the brain to reduce appetite and increase feelings of fullness, while also improving insulin sensitivity.
Ozempic
Ozempic is another injectable form of semaglutide, but in lower doses (0.5 mg and 1 mg) and primarily approved for managing type 2 diabetes. It is sometimes used off-label for weight loss under medical supervision. According to the American Diabetes Association (ADA), Ozempic helps lower blood sugar levels, improve insulin function, and can also support modest weight loss, typically around 5–10 per cent of body weight when combined with lifestyle changes.
Several studies have shown that patients with type 2 diabetes who take Ozempic not only improve glycemic control but also reduce cardiovascular risks. For example, the SUSTAIN-6 trial, published in The Lancet, found that semaglutide reduced the risk of major cardiovascular events in high-risk adults by 26 per cent. While its weight-loss effects are less pronounced than Wegovy, it is often prescribed for patients with obesity and diabetes.
Mounjaro (tirzepatide)
Mounjaro is a dual-action injectable medication that targets GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptors. It is approved for treating type 2 diabetes, and its weight-loss formulation, called Zepbound, is used for obesity management. Dosages range from 2.5 mg to 15 mg weekly.
Clinical trials, such as the SURPASS-1 to SURPASS-5 studies, show that tirzepatide can lead to significant weight loss and improved blood sugar control. In some trials, patients lost up to 20–22 per cent of their body weight over 72 weeks, surpassing many existing diabetes and weight-loss medications. Researchers believe its dual action—affecting both GLP-1 and GIP hormones, enhances appetite suppression and metabolic benefits.
Prescription and supervision
All three drugs, Wegovy, Ozempic, and Mounjaro are prescription-only medications and should be taken under the supervision of a qualified healthcare provider. The WHO, FDA, and other health authorities warn monitoring for side effects, such as nausea, vomiting, digestive issues, and potential long-term risks, before starting or continuing therapy.
These medications are part of a broader treatment strategy for obesity that combines lifestyle changes, and dietary changes. Studies show that patients who follow a comprehensive program, including medication and lifestyle changes, have the best long-term outcomes.
How do weight loss drugs help?
GLP-1 is a hormone released during meals that slows down the stomach emptying, helps the body absorb nutrients, increases insulin release, and makes the brain feel full. Drugs like Wegovy mimic this hormone, reducing hunger and helping people eat less.
When combined with a healthy diet and exercise, these drugs can help manage weight, type 2 diabetes, heart problems, and conditions like polycystic ovarian syndrome (PCOS).
Side effects and risks of weight loss drugs
Like all medicines, GLP-1 drugs have side effects. Common ones include nausea, vomiting, constipation, stomach pain, and indigestion. Tirzepatide may also reduce appetite.
Long-term effects are still being studied. In the UK, regulators launched a study after some patients experienced pancreatic problems. Women taking these drugs are advised to use effective birth control, as some pills may not work as well.
Stopping the drug can also lead to weight regain. A 2022 study found that people who stopped taking semaglutide regained about two-thirds of their lost weight within a year. This means long-term use is usually necessary.
What this means for India
India is one of the countries hardest hit by obesity. A Lancet study shows nearly 70 per cent of Indians are overweight or obese. More than 100 million people in India have diabetes, with another 136 million pre-diabetic.
GLP-1 drugs could help control this growing health problem. Clinical trials show patients can lose 15–20 per cent of their body weight, sometimes more than surgery. A 2023 Novo Nordisk trial on over 17,000 adults with heart disease (but no diabetes) found semaglutide reduced the risk of major heart problems like heart attacks for up to five years.
Still, doctors caution that these drugs are not a magic solution. They are expensive, require long-term use, and must be taken with medical supervision.
The guidance is still in draft form, and countries and experts have until September 27 to provide feedback. Once finalised, it could help millions of people worldwide manage obesity safely and effectively.
With these drugs, patients have hope not just for weight loss, but also for reducing serious health risks associated with obesity.