The World Health Organization recommends Ozempic-style medication as a long-term obesity treatment

Ozempic drug therapy has been approved as a long-term treatment for obesity under new guidelines released by the World Health Organization (WHO), which is calling on governments and health systems around the world to make the treatment more affordable and accessible to everyone.

However, the WHO has warned that even if production scales up rapidly, fewer than 10 per cent of weight loss drugs are expected to benefit by 2030.

In response to growing public health challenges, the WHO has developed guidelines for the use of glucagon-like peptide-1 (GLP-1)-based drugs such as Ozempic and Wegovy in obese people.

The guidelines, published overnight in the Journal of the American Medical Association (JAMA), recommend the use of long-term GLP-1 therapy for weight management in obese adults, alongside behavioral treatments such as physical activity, diet, and regular counseling sessions.

WHO Director-General Tedros Adhanom Ghebreyesus said: “Obesity is a major global health challenge and WHO is committed to addressing it by supporting countries and people around the world to manage obesity effectively and equitably.”

“Our new guidance recognizes obesity as a chronic disease that can be treated with comprehensive, lifelong care.

“Medicines alone cannot solve this global health crisis, but GLP-1 therapy can help millions of people overcome obesity and reduce the harms associated with it.”

What are GLP-1 drugs?

GLP-1-based drugs are breakthrough drugs that mimic the activity of natural hormones, slowing down digestion and helping you feel fuller for longer.

They were originally developed to treat patients with type 2 diabetes, but have gained attention for helping people manage obesity.

The WHO said the guidelines marked a change in the way obesity is treated in societies around the world, recognizing obesity not as a “lifestyle disease” but as a “chronic, relapsing disease that requires lifelong care.”

The guidelines were released hours after Australia's medicines regulator released the guidelines. A safety warning for people taking GLP-1-based drugs such as Ozempic and Wegovy about the potential risk of suicidal thoughts and behavior.

Obesity remains a leading cause of chronic disease and premature death, affecting more than 1 billion people worldwide, and cases are increasing in almost every country in the world.

Last year, there were 3.7 million obesity-related deaths from non-communicable diseases, and the global economic impact is projected to reach $3 trillion annually by 2030, the WHO said.

Peter Shepherd, professor of molecular medicine and pathology at the University of Auckland, said the paper highlighted the recognition of medical treatment as an important tool in the treatment of obesity.

“In 100 years, the world has gone from a global health crisis of global malnutrition to a current state of excess weight,” he said.

“A major barrier to effective treatment of obesity is our lack of understanding of our appetite and the biology that drives fat storage.

Prices are expected to fall as patents expire

The JAMA paper also notes that “high costs, limited manufacturing capacity, and supply chain constraints remain major barriers to universal access to GLP-1 therapies.”

Addressing the issue will require collaboration between public and private partners, WHO said, noting that the global patent for semaglutide, known by the brand names Ozempic or Wegovy, will start expiring in some countries from next year.

Professor Shepherd said this would make the drug more accessible.

“One of the issues is cost…many people report significant savings on food costs while taking these drugs, but this remains out of reach for many,” he said.

“The good news is that the patent on the main ingredient is about to expire and many competitors are ready to enter the market, so prices are sure to come down.

“Another question is what the long-term side effects will be. We already know that muscle loss from these drugs can be a potential problem, especially in older people, so careful monitoring is needed.”

Seeking subsidies for medicines

Different types of GLP-1 drugs are approved for use in diabetes and chronic weight management in Australia.

However, the treatment of type 2 diabetes is only subsidized in certain cases by the Pharmaceutical Benefits Scheme, meaning some people are personally paying as much as $700 per month for the script.

A preliminary study led by the University of New South Wales last month found that since 2020, total sales of GLP-1-type drugs in Australia have increased almost tenfold, reaching around 500,000 each month by 2024-25, with an estimated 500,000 people currently using them.

The Royal Australian College of General Practitioners (RACGP) is calling for the obesity drug to be subsidized on the PBS, arguing it will reduce health inequalities and remove significant cost barriers for many Australians.

In March, Health Minister Mark Butler wrote to the Pharmaceutical Benefits Advisory Committee (PBAC) covered by the PBS, asking for advice on equitable access to GLP-1 medicines for the treatment of obesity through the PBS.

The WHO has issued a “global call” to its 194 member states, including Australia, to ensure that services for obesity management are available, affordable and sustainable around the world.

“With early and sustained intervention to reduce and in some cases eliminate associated comorbidities, effective management and reversal of obesity at all ages is now a realistic prospect,” the paper concludes.

“How society responds to this opportunity will determine whether this truly marks the beginning of a new, more just era, or whether it is a missed opportunity to record a historic global health success story.”