For the first time, scientists at the World Health Organization (WHO) have endorsed a new class of drugs known as GLP-1 receptor agonists, which mimic the hormone that controls appetite and blood sugar levels, for obesity management.
They argue that current policies promoting healthy eating and physical exercise, while scientifically sound, have failed to stem the obesity epidemic. A new class of GLP-1 receptor agonists, which includes drugs such as semaglutide and tirzepatide, “has the potential to be transformative,” they say.
Dr Francesca Celletti and Dr Francesco Branca of WHO’s Department of Nutrition and Food Security and Dr Jeremy Farrar, WHO’s Chief Scientist, wrote, “Efforts to reduce the obesity epidemic have focused only on policies that help embed healthy diets and regular physical activity…there is good evidence on the effectiveness of such policies.” are …, it is time to identify multisectoral efforts to influence behavior … that have so far failed to treat obesity or turn the tide in the obesity epidemic. are In this context, GLP-1 has the potential to evolve into a new class of RAs.”
Why is this important?
The approval comes at a time when the patent for semaglutide, a popular drug in several countries including India and Brazil, is set to expire in the next two years. In India, many manufacturers of generic compounds have already started bioequivalence tests for their products so that they can be ready for use once the patent expires. Bioequivalence tests are conducted to ensure that generic versions of products are as safe and effective as branded versions. Several new drugs in this category are also in trials worldwide.
Globally, one in eight people will be living with obesity in 2022. There will be 890 million adults and 160 million adolescents living with obesity in 2022. According to the WHO, the prevalence of obesity has doubled in adults and quadrupled in adolescents since 1990. In India, 44 million women and 26 million men were living with obesity in 2022. In the three decades from 1990 to 2022, the prevalence of obesity increased by 8.6 percent in women and 4.9 percent in men. There has also been a significant increase in childhood obesity over three decades. In 1990, 0.2 million boys and 0.2 million girls were obese, and in 2022, 7.3 million boys and 5.2 million girls were obese. Scientists at the World Health Organization say the global costs associated with obesity are likely to reach $3 trillion by 2030. In countries with a prevalence of 30% obesity, it can absorb up to 18% of national health expenditure. Scientists also argue that obesity adds to mortality — 5 million obesity-related deaths from non-communicable diseases in 2019. This is 12 percent of deaths from non-communicable diseases worldwide.
WHO will also issue guidelines for use?
The WHO is currently in the process of drafting guidelines for the use of GLP-1 receptor agonists in adults with obesity to provide clarity on “clinical indications, application and programmatic considerations globally”. These guidelines are likely to be published in July 2025.
What are the popular diabetic weight loss drugs?
Novo Nordisk’s Ozempic, originally approved for type 2 diabetes in 2017, became wildly popular after doctors prescribed it off-label for obesity, fueled by a social media frenzy and a supply shortage. In 2021, the USFDA approved Novo Nordisk’s other semaglutide-based drug Wegovy, marking the first chronic weight management treatment in a decade. Meanwhile, Eli Lilly’s Zipbound, approved in 2023, and its diabetes drug Monzaro, also used off-label for weight loss, have joined the ranks of high-demand treatments for obesity care.
The WHO also raised a red flag
Although the new therapy has been shown to reduce body weight by 10 to 25 percent, experts say it should not be used by everyone because of serious side effects such as gastroparesis (stomach paralysis), pancreatitis (swelling of the pancreas) and thyroid cancer. Another important consideration is that weight gain is likely when a person stops using the drug, and it remains to be seen whether the drug will continue to work for many years.
Given the high cost of production, high demand and production and supply challenges, scientists have also raised the issue of “counterfeit products” and the gray market. However, there is a possibility that the medicines will be readily available after the patent is off.
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