Background
No country is immune to the impacts of the obesity epidemic. In 2022, 37 million children under the age of five1 and 2.5 billion adults (18 years and older) were overweight. Of these adults, 890 million were living with obesity2. To make matters even more pressing, the earlier prediction made that over one billion people live with obesity by 20303 has already been surpassed. The health risks caused by overweight, and obesity are increasingly well-documented and understood. In 2019, higher-than-optimal BMI caused an estimated 5 million deaths from noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, cancers, neurological disorders, chronic respiratory diseases, and digestive disorders. This combination of fast-rising prevalence and significance as a risk factor for other NCDs means that obesity now represents one of the major public health challenges of our time.
At the request of the WHA, WHO developed a WHO Acceleration plan to stop obesity joined by 32 frontrunner countries. The plan includes, among others, a health service delivery component. Several of the frontrunner countries included the integration of prevention and management of obesity as part of primary health care as a priority. In relation to this topic, the evidence about increased efficacy of Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs) in the management of obesity, compared to previous anti-obesity medicines, supported by the approval by FDA and other regulatory agencies, has generated interest in clinicians, people with obesity and society at large and their demand is rapidly increasing. Yet clinical and public confusion exists around indications, side effects, real-world costs, tolerability, duration, and access. In addition, with 1 billion people with obesity spread globally across all age groups, including in low- and middle-income countries – should their indication be validated - questions are also rising on the inclusion of these medicines as part of the public health approach needed to address the obesity epidemic.
Scope and purpose
The scope of this living guideline will be focused on the use of GLP-1 receptor agonists in the management of people who are living with obesity as defined by BMI criteria and/or associated weight-related comorbidities. This scope will first include providing a thorough review of the benefits and harms of these agents to understand the indications for their use and secondly, guide their potential integration into a multimodal chronic care model for the management of obesity that also includes programmatic, access and equity considerations.
Eighteen experts from various backgrounds were identified worldwide and selected to form the Guideline Development Group (GDG). The role of the GDG is to provide technical and/or normative advice and recommendations to WHO. The names and brief biographies of individuals being considered for participation in the GDG are hereby published for public notice and comment.
Comments and perceptions brought to the knowledge of WHO through this process are an integral component of WHO’s Conflicts of Interest assessment policy as to strengthen public trust and transparency in connection with WHO meetings involving the provision of technical/normative advice. Comments and perceptions will be carefully reviewed and treated confidentially. The comments will not be published and will be kept in record. WHO reserves the right to discuss information received through this process with the relevant expert with no attribution to the provider of such information. Upon review and assessment of the information received through this process, WHO, in its sole discretion, may take appropriate management action in accordance with its policies. The participation of an expert in a WHO meeting does not imply that they are endorsed or recommended by the World Health Organization, nor does it create a binding relationship between the expert and WHO. The list of participating experts, a summary of relevant interests disclosed by such experts, and any appropriate mitigation measures taken by WHO relating to the management of conflicts of interest, will be reported publicly in accordance with WHO practice.
Comments should be provided by email, and the receipt of these will be acknowledged through generic email notification to the sender.
Please send your comment to obesity@who.int with the subject, “Public notice and comments on the WHO living guideline on the use and indications of glucagon-like peptide-1 receptor agonists for management of adults living with obesity” with indication of the name, nature and contact details of the sender.
The deadline for public comments is on 8 September 2024.
2 Obesity and overweight fact sheets
3 World Obesity Federation. World Obesity Atlas 2022