The global obesity epidemic has more than doubled over the past three decades, leading to a surge in related diseases such as diabetes, cardiovascular issues, and various cancers. This growing public health crisis is exerting immense pressure on healthcare systems and economies worldwide. However, a recent study co-led by researchers from Mass General Brigham suggests that GLP-1 medications could be a pivotal part of the solution.
Researchers from Mass General Brigham, in collaboration with Washington University School of Medicine in St. Louis and Emory University’s Rollins School of Public Health, analyzed data from 99 countries involving 810,635 adults. Their findings indicate that more than one in four adults globally could be eligible for GLP-1 medications for weight management. The study highlights that women, older individuals, and residents of low- and middle-income countries are among the most likely to benefit. These insights, published in The Lancet Diabetes & Endocrinology, could inform policy development for the global deployment of GLP-1s to combat obesity and its associated health issues.
Understanding the Potential of GLP-1 Medications
GLP-1 receptor agonists have been recognized by the World Health Organization (WHO) as potentially transformative tools in addressing obesity, type 2 diabetes, and other related health complications. Co-senior author Jennifer Manne-Goehler, MD, ScD, emphasized the paradigm shift these medications represent. “For so many decades, we told everyone the problem was you—you need to move more and eat less,” she stated. “GLP-1 receptor agonists have allowed us to really understand that biology is much more powerful than that.”
The widespread application of GLP-1s, however, hinges on a critical question: How many people truly need them? According to corresponding author Sang Gune K. Yoo, MD, the study’s findings are not surprising given the rising prevalence of obesity. “This medication has the potential to help many individuals, although further research is needed to better understand its long-term safety and sustainability,” Yoo noted.
Eligibility and Global Impact
The study utilized household health survey data collected from 2008 to 2021. Adults aged 25 to 64 were assessed based on diabetes biomarkers, blood pressure, BMI, and diagnostic history of hypertension and diabetes. Those with a BMI over 30, or over 27 with additional health issues, were deemed eligible for GLP-1 use.
Globally, 27% of adults were eligible for GLP-1s for weight management, with the highest eligibility rates in Europe and North America (42.8%) and the Pacific Islands (41.0%). Women were more likely (28.5%) than men to be eligible, and older individuals were more likely (38.3%) than younger adults (17.9%).
These findings underscore significant socioeconomic and gender disparities. Manne-Goehler pointed out that type 2 diabetes was the leading cause of death for women in South Africa last year, highlighting the urgent need for accessible treatments in these regions.
Challenges and Future Directions
Despite the promising potential of GLP-1s, access remains a significant challenge. “Global access to GLP-1s is a question of health equity,” said co-lead author Felix Teufel, MD. “The goal is to ensure large-scale access for people who would benefit most—not just those easiest to reach.”
While scaling up production and distribution of GLP-1s is a priority, experts like Yoo stress the importance of continuing to develop effective non-pharmacological strategies for obesity prevention and treatment. This approach is crucial given the substantial gaps that remain in this area.
Conclusion and Next Steps
The study’s authors, including a diverse team of international researchers, emphasize the need for comprehensive strategies to address the obesity epidemic. As the world grapples with increasing obesity rates, the integration of GLP-1s into global health strategies could mark a significant advancement in public health.
Funding for the study came from various sources, including grants from the National Institutes of Health and the US National Heart, Lung, and Blood Institute. The research letter, authored by Yoo SGK et al., is titled “GLP-1 receptor agonist for obesity: eligibility across 99 countries” and is available in The Lancet: Diabetes and Endocrinology.
