The lancet. Diabetes & endocrinologyOct 19, 2026

The progress of obesity medicine: from early problems to WHO approval

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Oct 20, 2026

Abstract

Obesity is a chronic disease that is associated with increased morbidity and reduced life expectancy.

Global prevalence of obesity has risen sharply in recent decades.
Pharmacotherapy for obesity has been historically underused due to stigma and safety concerns related to early medications.
Recent advancements in treatments, particularly GLP-1 receptor agonists and multiagonist therapies, show greater efficacy and safety compared to older medications.
The World Health Organization has included GLP-1 receptor agonists in its Essential Medicines List for a narrowly defined population, reflecting a shift in treatment approach.
Factors such as scientific, regulatory, and societal challenges have impeded the acceptance and use of pharmacological treatments for obesity.

Simplified

Obesity is a chronic, progressive disease associated with disability, increased morbidity, and reduced life expectancy. Global prevalence has risen sharply in recent decades, yet obesity and its treatment-particularly pharmacotherapy -have been highly stigmatised. A legacy of early medications withdrawn over safety concerns, together with poor efficacy, and widespread lack of recognition of obesity as a chronic disease contributed to persistent underuse of obesity pharmacotherapy. This underuse changed in the 2020s with GLP-1 receptor agonists and, later, multiagonist therapies, with their substantially greater efficacy, safety, and disease-modifying benefits compared with older agents. Reflecting this paradigm shift, WHO issued global guidelines and included GLP-1 receptor agonists in the Essential Medicines List, albeit for a narrowly defined population. We take a critical historical perspective, charting the highs and lows of obesity medication development and examining the scientific, regulatory, and societal factors that have slowed or impeded the translation of pharmacological advances into safe, effective, and widely accepted treatments for obesity.

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The progress of obesity medicine: from early problems to WHO approval

Abstract

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