The WHO learned to love ‘anti-obesity’ jabs in 2025. I don’t fully agree, but I get it | Devi Sridhar

IIf there was a hot topic in the field of health in 2025, it was GLP-1, colloquially called “anti-obesity” vaccines. These drugs, taken weekly as an injection into the abdomen, cause significant weight loss and, although they were developed to manage type 2 diabetes in people with metabolic disorders, have become common in many countries as a treatment for obesity. Clinicians rave about the health results of patients taking this drug, with study after study investigating the health benefits of associated weight loss in obese people. Celebrity endorsements, online sales, and off-label use have made them widely used by people of all ages and sizes who want to lose weight.

For the public health community, this is a strange time. For years, we’ve been advocating for government action on obesity – not through new drugs, but by taking nutrition and food systems seriously. We highlighted the need for government action to make nutritious food affordable, regulate ultra-processed foods, introduce sugar taxes and ban the advertising of unhealthy products to young people, while encouraging an increase in physical activity. The solutions are simple: get people to eat more nutritious foods and get moving. The challenge has been implementation, particularly in disadvantaged areas.

So when GLP-1 drugs such as semaglutide began to be used as a widespread weight loss solution, resulting in huge profits for pharmaceutical companies, the initial reaction in public health circles was somewhere between horror and exasperation. Not because the drugs weren’t effective, but because they symbolized a kind of abandonment. After decades of fighting to change the culture of diet and physical activity, now a pharmaceutical company is proposing a weekly injection as an answer to a problem created by the transnational food industry.

The irony is not lost on me. A group of companies profits by making populations obese; another is now taking advantage by promising to reverse the trend, at least as long as people can continue to pay and inject. We still don’t know the long-term side effects of these medications, especially in people with a healthy weight and normal metabolic function.

But over the past year, more countries have moved toward deploying GLP-1 drugs as the primary treatment for obesity. In fact, the World Health Organization (WHO) recently recommended GLP-1 drugs as a treatment for obesity in all countries. For decades, the WHO resisted pharmaceutical solutions to obesity, insisting that the crisis was environmental, structural and political. The agency is now saying something different: People are dying from obesity-related illnesses all over the world, and we have a tool that works.

For some, it’s a capitulation. Was 2025 the year global health finally gave up on tackling the social and commercial causes of obesity and talked about nutrition? Obesity rates are closely linked to socioeconomic status. In fact, childhood obesity is said to be a reflection of child poverty. GLP-1s were created to medically treat people suffering from a metabolic disorder. Are we saying that the poorest 20% of people (who have higher obesity rates) have a metabolic disorder that the richest 20% do not have? Certainly not.

We know that food is linked to income, time, education and resources. If obesity can be “cured” with a vaccine, why attack the food industry? Why invest in affordable fruits and vegetables or healthy school meals? GLP-1s have become a way for many politicians to appear to be taking action while avoiding addressing the systematic problems in food production and consumption that are making us sick.

But I can understand the WHO’s pivot, because obesity is not a theoretical problem that we have time to solve. It kills people and handicaps them in their daily lives. Just ask any clinician about the impact of these medications on people with heart disease, diabetes, fatty liver disease, joint failure…the list goes on. It’s all well and good to talk about overhauling food systems, but we now have a drug that reliably reduces weight, improves metabolic markers, and reduces cardiovascular risk. In this context, you can understand that doctors see the health benefits for their patients and that the WHO advocates for these medicines to be made affordable and accessible everywhere in the world, including in low-income countries.

We must still be attentive to the reality of these medications for individuals. They require a weekly injection, potentially creating a lifelong addiction, since studies have shown that weight rebounds when they are stopped. They have side effects and can cause serious complications, especially in people who have not prescribed them by a doctor. They also don’t eliminate the need for a nutritious diet. Just as you can be overweight and malnourished, you can also be thin and malnourished.

Additionally, weight loss alone does not provide the health benefits of physical activity. Exercise strengthens the heart, builds muscle, protects the brain from depression, anxiety and dementia, and helps reduce chronic pain. Perhaps 2026 will see the arrival of an exercise pill, but so far we don’t have a drug that can mimic its benefits. Despite all the promise of GLP-1, the body still needs what it has always needed: an affordable, accessible nutritious diet and daily exercise. It may be a pipe dream, but I hope the coming year brings societal changes that make this possible for all of us, without the need for a weekly shot.

• Professor Devi Sridhar is Chair of Global Public Health at the University of Edinburgh

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