In a groundbreaking move that signals a new approach to the global obesity epidemic, the World Health Organisation (WHO) has for the first time added weight-loss injections to its Essential Medicines List (EML).
The decision, made by the WHO's expert committee, recommends the inclusion of the drug liraglutide, a GLP-1 receptor agonist sold under brands like Saxenda. This paves the way for newer, more effective injections like semaglutide (Wegovy, Ozempic) to be considered in the future.
A New Chapter in Obesity Treatment
The update to the EML marks a significant shift in how health bodies view pharmacological interventions for weight management. For decades, the list has focused on treatments for infectious diseases and basic healthcare needs. The inclusion of anti-obesity medications recognises obesity as a chronic, complex disease requiring long-term management strategies beyond diet and exercise alone.
The WHO expert panel concluded that evidence now supports the use of GLP-1 receptor agonists “for adults with a body mass index (BMI) greater than or equal to 35 kg/m² without diabetes, or for adults with a BMI of 30–34.9 kg/m² with at least one weight-related comorbidity.”
Addressing a Global Health Crisis
This decision is a direct response to the staggering rise in global obesity rates. The WHO estimates that over 650 million adults worldwide are now obese, a figure that has nearly tripled since 1975. The condition is a major risk factor for a host of other diseases, including:
- Type 2 Diabetes
- Cardiovascular disease
- Certain types of cancer
- Musculoskeletal disorders
By classifying these drugs as 'essential', the WHO aims to improve global access and spur competition, potentially lowering prices for healthcare systems and patients. This is particularly relevant for the NHS, which is grappling with the high cost of rolling out these treatments on a mass scale.
Challenges and Considerations
The recommendation comes with a major caveat. The WHO panel explicitly stated that the long-term safety and efficacy of these drugs is not yet fully established. They emphasised that their use must be paired with “lifestyle interventions (diet and physical activity)” and that patients must be monitored for potential side effects.
This cautious optimism reflects concerns about the novelty of these treatments and their known side effects, which can include gastrointestinal issues. The high cost and potential supply chain issues for these biologics also present significant hurdles for widespread adoption in lower-income countries.
Nevertheless, this landmark decision by the WHO legitimises a new class of pharmaceuticals in the public health fight against obesity, promising a new tool for doctors and patients worldwide.
