Abstract:
The World Health Organization (WHO) issued the Guideline on glucagon-like peptide-1 (GLP-1) therapies for the treatment of obesity in adults in 2025 to address the growing global burden of obesity, a chronic, progressive, and highly recurrent disease that has long been inadequately managed as a long-term condition. This guideline applies to adults aged ≥20 years with obesity defined as a body mass index (BMI) ≥30 kg/m², and its evidence base is limited to liraglutide, semaglutide, and tirzepatide. Using systematic reviews, the GRADE methodology, an Evidence-to-Decision framework, and rapid qualitative evidence synthesis with GRADE-CERQual assessment, the guideline developed two good practice statements and two conditional recommendations. First, obesity should be incorporated into lifelong chronic disease management, with long-term, follow-up-based care and context-specific behavioral and lifestyle counseling as the foundation of intervention. Second, GLP-1 receptor agonists or GIP/GLP-1 dual agonists may be considered for long-term treatment in adults with obesity, while intensive behavioral therapy may be combined with pharmacological treatment when resources and individual circumstances permit. The conditional nature of these recommendations reflects remaining uncertainties regarding long-term efficacy and safety, treatment discontinuation and maintenance strategies, cost-effectiveness, access, implementation capacity, and health equity. For China, the guideline should be interpreted cautiously because the WHO definitions of adulthood and obesity differ from commonly used domestic criteria, and substantial regional disparities exist in drug accessibility, payment capacity, primary-care follow-up, and multi-disciplinary resources. Therefore, implementation should be adapted to local diagnostic standards, health care delivery models, tiered management pathways, and sustainable follow-up systems to support equitable and standardized obesity care.
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