The World Health Organization (WHO) has published landmark guidelines conditionally recommending treating obesity with Ozempic-like medications, amid a global explosion in their use.
The WHO guidelines refer to the use of three Glucagon-Like Peptide-1 (GLP-1) medications: liraglutide (marketed as Saxenda or Victoza), semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro).
The WHO said it was making "conditional recommendations" for the long-term use of these therapies to support people living with obesity, as part of an approach that includes "healthy diets, regular physical activity and support from health professionals".
Conditional recommendations made by the organisation are made when it is uncertain whether the desirable consequences of the recommendation outweigh undesirable consequences.
The recommendations included that GLP-1 medications may be used as long-term treatment for obesity, excluding pregnant women, and that they may be provided alongside other interventions such as counselling and physical activity and diet goals.
WHO director-general Dr Tedros Adhanom Ghebreyesus said the new guidance "recognises that obesity is a chronic disease that can be treated with comprehensive and lifelong care".
"While medication alone won't solve this global health crisis, GLP-1 therapies can help millions overcome obesity and reduce its associated harms," he said.
Associate professor Garron Dodd, head of the Metabolic Neuroscience Research Laboratory at the University of Melbourne, told SBS News the guideline is "historic" as it's the first time the WHO has "recognised obesity as a chronic disease requiring lifelong management and not just a failure of an individual's willpower".
Increasing number of Australians on GLP-1 drugs
The popularity of GLP-1 medications has exploded internationally in recent years.
Nearly 500,000 Australians — almost 2 per cent of the adult population — are using these drugs for weight loss or medical reasons, according to a report led by researchers at the University of New South Wales (UNSW), which has not yet been peer reviewed.
The numbers represent a 10-fold increase from May 2020 to April 2025 — they are also likely an underestimate as there may be more GLP-1 medicines that weren't examined in the report.
The guideline came a day after Australia's medicines regulator updated product warnings for GLP-1 medicines for the potential risk of suicidal thoughts and the potential for reduced effectiveness of oral contraception when first taking or increasing the dose of Mounjaro.
The WHO said it developed the guideline in response to requests from member states on how to address challenges associated with obesity.
Obesity was associated with 3.7 million deaths worldwide in 2024, according to the WHO and it said that without "decisive action, the number of people with obesity is projected to double by 2030".
Obesity is defined as having a Body Mass Index (BMI) of 30 or higher in adults, although some experts are calling for more nuanced measures.
In Australia, one in four children aged two to 17 are considered overweight or obese and around 31 per cent of adults are obese.
'Not a silver bullet'
Dodd said that while GLP-1 medications are having "transformative" effects on society, they are not a "silver bullet" when it comes to treating obesity.
"Obesity is very complex, there's very complex biology that underpins it that GLP-1 [medications] just don't touch. They target symptoms but they don't really target the underlying root causes," he said.
Dodd said the next wave of drug development is focusing on trying to target the underlying mechanisms of obesity and diabetes.
However, some experts also emphasise that obesity prevention still needs to be a point of focus.
Dr Jennifer Wong, head of diabetes at Monash Health, told SBS News that while obesity should be recognised and treated as a chronic disease, Australians live in an 'obesogenic' environment and policies about diet and exercise education are still important.
Emeritus professor Elaine Rush, from the Riddet Institute at Auckland University of Technology, told SBS News that while she believes some people need to use GLP-1 medications, she would prefer to see broader, future-oriented recommendations and policies to address obesity.
"It's diet and the quality of the diet and the frequency of it. It's physical activity, it's reduction of stress and it's also being able to breathe fresh air — which means not smoking but also having non-polluted cities," she said.
"They are all things that could be prevented or reduced if only we focused on the future, rather than the immediate treatment."
While the WHO guidelines acknowledge that GLP-1 therapies are the first "efficacious treatment option for adults with obesity", they also stress that obesity is a challenge that requires action across societies.
WHO has outlined three pillars of addressing the causes of obesity, including creating healthier environments, protecting high-risk individuals and ensuring access to lifelong, person-centred care.
'Limited' long-term data
Wong also said the long-term efficacy and safety of GLP-1 medications is "still unclear" as they are still relatively new drugs.
"We've had people with type 2 diabetes using them for a long period of time without any significant complications but I think we just need more longer-term data and that's going to be real-world data as well," she said.
While the WHO guideline said GLP-1 therapies can be used by adults for long-term treatment of obesity, it also acknowledged there is "limited data" on long-term efficacy and safety of these medications.
The WHO said its guideline will be continuously updated and expanded in response to evolving evidence and real-world data.
This week, the Therapeutic Goods Administration (TGA) updated its product warnings for GLP-1 drugs to include potential risk of suicidal thoughts or behaviours, following investigations by the TGA and international regulators.
'Costly' medication
The significant costs associated with GLP-1 medications also continue to be a barrier to access in Australia.
In its guideline, the WHO called for fair access to GLP-1 therapies and said "deliberate policies" were needed to overcome health disparities.
"Not many [patients] can stay on it for a long period of time because it is very costly," Wong said.
Ozempic can cost between $130 and $200 per month, adding up to over $2,000 a year.
The profits for makers of GLP-1 medications are also difficult to ignore.
Eli Lilly, manufacturer of tirzepatide products marketed as Mounjaro and Zepbound, was valued at $1.5 trillion last week, making it the first drugmaker to enter an exclusive club dominated by tech giants.
The Royal Australian College of GPs has called on the government to subsidise GLP-1 drugs on the Pharmaceutical Benefits Scheme.
However, Wong said the overall cost of these medications to the government would be immense.
Dodd believes the GLP-1 drugs are likely to become cheaper in coming years.
Expiring patents on certain GLP-1 medications (the semaglutide patent — Ozempic, Wegovy — will finish in some countries starting from next year), the release of oral alternatives that don't require expensive storage, and increased competition from intensive research and development will all contribute to lowering costs, Dodd said.
"In terms of research, this is probably one of the — if not the — hottest areas of science right now."
With additional reporting by Reuters.
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