This is huge news and we’ve been waiting for it a very long time. For the first time ever, the World Health Organization (WHO) is embracing obesity treatment in a new global guidance issued yesterday. From the head of WHO, Director-General Tedros Adhanom Ghebreyesus, came words we wondered if we would ever hear:

“Our new guidance recognises that obesity is a chronic disease that can be treated with comprehensive and lifelong care.

“While medication alone won’t solve this global health crisis, GLP-1 therapies can help millions overcome obesity and reduce its associated harms.”

Until now, WHO has treated obesity as a risk factor for other diseases. But not as a chronic, non-communicable disease (NCD) itself. The implication and the longstanding bias has been, until now, to treat obesity as a “modifiable behavioral risk factor.” The WHO strategy to address NCDs in 2018 did not even mention “obesity.” It only called out “unhealthy diet” and “physical inactivity” as risk factors for a list of NCDs that excluded obesity.

Access to Treatment and Prevention

In contrast to its prior, now obsolete thinking about obesity, WHO states its new perspective quite clearly in JAMA:

“The guidelines recognize obesity as a chronic, relapsing disease requiring lifelong care and emphasize early diagnosis and integrated, person-centered approaches combining behavioral, medical, surgical, and other interventions alongside prevention and management of comorbidities. WHO recommends long-term GLP-1 therapies combined with intensive behavioral therapy to maximize and sustain benefits.

“Medication alone cannot solve the global obesity burden. The availability of GLP-1 therapies should galvanize the global community to build a fair, integrated, and sustainable obesity ecosystem. Countries must ensure equitable access not only to comprehensive disease management, but also to health promotion and prevention policies and interventions targeting the general population and those at high risk.”

No longer is WHO framing obesity as a behavioral problem to be addressed solely by prevention. WHO has clearly moved on.

Make no mistake. It is good news to see WHO embracing a balanced approach to treatment and prevention of obesity. Joe Nadglowski, CEO of the Obesity Action Coalition, sums it up quite well:

“I am encouraged to hear many thought leaders and organizations, who have been reluctant to talk about anything but prevention, begin voicing support for a balanced approach to prevention and treatment of obesity.”

Slowly, but surely, the world is getting real about obesity.

Click here for the special communication from WHO in JAMA. For further perspective, click here, here, and here.

Looking out on the World, self-portrait from the International Space Station by Tracy Caldwell Dyson for NASA / Wikimedia Commons