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The World Health Organization (WHO) released its first global guideline on January 6, 2026, establishing conditional recommendations for the long-term use of glucagon-like peptide-1 (GLP-1) receptor agonists to treat obesity as a chronic, relapsing condition. According to a WHO press release, the initiative aims to address a global health challenge affecting more than a billion people worldwide, a crisis linked to millions of deaths in 2024. Without decisive intervention, the organization projects that the number of people living with obesity will double by 2030.
Global Guidelines and Clinical Positioning
The new WHO guidance recognizes obesity as a complex, chronic illness that requires comprehensive and lifelong care, rather than relying solely on individual management. According to WHO Director-General Dr. Tedros Adhanom Ghebreyesus, “While medications alone will not solve this global health crisis, GLP-1 therapies can help millions of people overcome obesity and reduce the damage associated with it.” In September 2025, the WHO added GLP-1 therapies to its Essential Medicines List for treating type 2 diabetes in high-risk groups. The new guidelines establish two central conditional recommendations: adults, excluding pregnant women, can use GLP-1 therapies for long-term weight management, and intensive behavioral interventions—such as structured nutrition and physical activity programs—should accompany the prescriptions, despite low-certainty evidence supporting combined outcomes.
Reproductive Health and Pregnancy Evidence
Complementing the global public health directives, an international initiative published a systematic evaluation in the journal Obesity Reviews examining the use of incretin-based medications among women before, during, and after pregnancy. The review analyzed 34 studies, including randomized controlled trials, observational research, pharmacovigilance analyses, and case reports. According to the findings, current data show no indication that accidental exposure to incretin-based medications in early pregnancy increases the risk of major congenital malformations. However, the authors emphasize that substantial evidence gaps remain regarding long-term outcomes for both mothers and children.
Clinical Practice and Fertility Insights
The Obesity Reviews analysis indicates that incretin-based therapies may improve fertility in women with obesity and polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS). Despite these findings, the authors state that current evidence remains insufficient to support using these medications during pregnancy or lactation. Researchers noted that nearly half of all clinically relevant questions regarding reproductive health and incretin therapies remain unanswered, prompting a call for prospective studies and long-term investigations. Clinicians are advised to provide thorough contraceptive counseling and individualized risk-benefit assessments for women of reproductive age managing obesity.
Economic Impact and Comprehensive Care
Obesity remains a primary driver of noncommunicable diseases, including cardiovascular conditions, type 2 diabetes, and specific cancers, while also worsening outcomes for patients with infectious diseases. According to projections cited by the WHO, global economic costs related to obesity will reach trillions of dollars annually by 2030. The WHO emphasizes that medications represent only the first effective pharmacological option and must be integrated into a broader three-pillar strategy that includes population-wide preventive measures, health service reorganization, and supportive clinical environments.
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