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

If there has been a hot topic in health in 2025, it’s definitely been GLP-1s, colloquially referred to as “anti-obesity” jabs. These medications, taken weekly as an injection into the abdomen, result in significant weight loss and, despite being developed to manage type 2 diabetes in those with metabolic disorders, have become mainstream in many countries as a treatment for obesity. Clinicians rave about the health outcomes in patients taking the medication, with study after study emerging on the health benefits of the associated weight loss in those who are obese. Celebrity endorsements, online sales and off-label use have seen them widely used by people of all ages and sizes who want to drop weight.

For the public health community, it’s an odd moment. For years, we’ve advocated for government action on obesity – not through new drugs, but by taking nutrition and food systems seriously. We’ve highlighted the need for government action on making nutritious food affordable, regulating ultra-processed foods, bringing in sugar taxes and banning advertising of unhealthy products to young people, alongside encouraging an increase in physical activity. The solutions are simple: get people to eat more nutritious food and move. The challenge has been implementation, especially in deprived areas.

So when GLP-1 drugs such as semaglutide started to be used as a widespread weight-loss solution, resulting in massive profits for pharmaceutical companies, the first reaction in public health circles was something between horror and exasperation. Not because the drugs didn’t work, but because they symbolised a kind of surrender. After decades of fighting to change the food and physical activity culture, here came a pharmaceutical company offering a weekly jab as the answer to a problem created by the transnational food industry.

The irony isn’t lost on me. One set of companies profits by making populations obese; another now profits by promising to reverse it, at least for as long as people can keep paying and injecting. We still don’t know the long-term side effects of these drugs, especially in those within a healthy weight range and with normal metabolic function.

But in the past year, more and more countries have been moving towards rolling out GLP-1 drugs as the main treatment for obesity. In fact, the World Health Organization (WHO) recently recommended GLP-1 drugs as treatment for obesity in all countries. For decades, the WHO had resisted pharmaceutical solutions for obesity, insisting the crisis was environmental, structural and political. The agency is now saying something different: people are dying of obesity-related diseases across the world, and we have a tool that works.

For some, this is capitulation. Has 2025 been the year that global health finally gave up on fixing the social and commercial causes of obesity and talking about nutrition? Obesity rates are tightly linked to socioeconomic status. In fact, it’s been said that child obesity is a reflection of child poverty. GLP-1s were created to medically treat those with 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% don’t have? Surely not.

We know diet is linked to income, time, education and resources. If obesity is “treatable” with a jab, why take on the food industry? Why invest in affordable fruit and vegetables or healthy school lunches? GLP-1s have become a way for many politicians to appear to be doing something while avoiding dealing with the systematic food production and consumption issues 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’s killing people and disabling them in daily life. Just ask any clinician about the impact of these drugs on people with heart disease, diabetes, fatty liver disease, joint failure … the list goes on. It’s all well and good talking about redesigning food systems, but right now, we have a drug that reliably reduces weight, improves metabolic markers and reduces cardiovascular risk. In that context, you can understand doctors seeing the health benefits in their patients and the WHO advocating for these drugs to be made affordable and accessible all across the world, including in low-income countries.

We still need to be careful about the reality of these drugs for individuals. They require a weekly injection, potentially creating lifelong dependency, given that studies have shown that weight rebounds when they’re stopped. They have side effects and can cause serious complications, especially for people who aren’t prescribed them by a doctor. They also don’t negate the need to eat a nutritious diet. Just like you can be overweight and malnourished, you can also be thin and malnourished.

Plus, losing weight alone doesn’t bring 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 bring an exercise pill, but so far, we don’t have any drug that can mimic its benefits. For all the promise of GLP-1s, the body still needs what it has always needed: affordable and accessible nutritious food and daily movement. Perhaps it’s a pipe dream, but I hope the coming year will bring societal changes to make that possible for all of us, without needing a weekly jab.