The worldwide prevalence of obesity has more than doubled over the past three decades, leading to a surge in weight-related diseases such as diabetes, cardiovascular disease, and various cancers. This public health crisis poses significant challenges to global healthcare systems and economies. However, a recent study led by researchers from Mass General Brigham suggests that GLP-1 medications may offer a viable solution.
The research, conducted in collaboration with Washington University School of Medicine in St. Louis and Emory University’s Rollins School of Public Health, pooled data from 99 countries and 810,635 adults. The findings indicate that more than one in four adults globally could benefit from 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 eligible. These insights, published in a research letter in The Lancet Diabetes & Endocrinology, could guide policy development for the global deployment of GLP-1s to combat obesity and its related conditions.
GLP-1 Medications: A Transformational Tool
Dr. Jennifer Manne-Goehler, a co-senior author of the study and a physician at Brigham and Women’s Hospital, emphasized the potential impact of GLP-1 receptor agonists. “There has never been such a potentially transformational and scalable tool for obesity, type 2 diabetes, and other health-related complications of obesity,” she stated. Manne-Goehler noted that these medications challenge the traditional “eat less, move more” approach by highlighting the complex biological factors contributing to obesity.
The World Health Organization (WHO) has recognized the promise of GLP-1s and is working to make them standard, accessible medications. However, the global rollout of GLP-1s hinges on understanding the scale of need. “Given the steadily increasing prevalence of obesity, it’s not surprising that our analysis found that more than one quarter of adults around the world may be eligible for this medication,” said Dr. Sang Gune K. Yoo, the corresponding author of the study.
Challenges and Opportunities
Despite the promising potential of GLP-1 medications, several challenges remain. Access to these medications is limited in many regions, and further research is needed to assess their long-term safety and sustainability. Dr. Yoo emphasized the importance of continuing to develop effective non-pharmacological strategies for obesity prevention and treatment.
The study’s researchers utilized household health survey data collected from 99 countries between 2008 and 2021. They assessed adults aged 25 to 64 based on diabetes biomarkers, blood pressure, BMI measurements, and histories of hypertension and diabetes. Individuals with a BMI over 30 or a BMI over 27 with additional conditions were deemed eligible for GLP-1 use.
Globally, 27% of adults were eligible for GLP-1s for weight management—four-fifths of whom were from low- and middle-income countries. Eligibility rates were highest in Europe and North America (42.8%) and the Pacific Islands (41.0%). Women were more likely (28.5%) than men to be eligible, as were older individuals (38.3%) compared to younger adults (17.9%).
Implications for Health Equity
Dr. Felix Teufel from Emory University’s Rollins School of Public Health highlighted the equity implications of global access to GLP-1s. “The goal is to ensure large-scale access for people who would benefit most—not just those easiest to reach,” he explained. This underscores the need for equitable distribution strategies that prioritize vulnerable populations.
Dr. Manne-Goehler pointed out the staggering socioeconomic and gender disparities in eligibility. For instance, type 2 diabetes was the leading cause of death for women in South Africa last year, underscoring the urgent need for accessible treatments in certain regions.
Future Directions
The findings from this study could inform global health policies and initiatives aimed at addressing obesity and its comorbidities. The research team, which includes a diverse group of international experts, advocates for a multifaceted approach that combines pharmacological and non-pharmacological interventions.
As the global community grapples with the obesity epidemic, the insights from this study offer a roadmap for leveraging GLP-1 medications as part of a comprehensive strategy. The ongoing challenge will be to ensure that these medications are accessible to those who need them most, while continuing to explore sustainable and effective solutions for obesity prevention and management.
For more detailed findings, the full research letter can be accessed in The Lancet Diabetes & Endocrinology.
