In December 2025, the World Health Organization (WHO) released its first global guideline on using GLP-1 medicines to treat obesity in adults. This is a major milestone: it recognizes obesity as a chronic, treatable disease and endorses GLP-1–based medications as a long-term option, alongside nutrition and physical activity, for people who meet certain criteria.
Many of our patients have questions about what this change means, especially if they are already taking a GLP-1 for diabetes or are wondering whether weight-loss medications might be right for them. Here’s a plain-language look at the guideline and how we think about these therapies in our clinics.
What are GLP-1 medicines?
GLP-1 (glucagon-like peptide-1) receptor agonists and related “dual” incretin drugs mimic hormones that help regulate blood sugar, appetite, and digestion. They can:
- Lower blood sugar
- Support significant, sustained weight loss
- Improve blood pressure and cholesterol
- Reduce the risk of heart and kidney complications in people with type 2 diabetes
WHO’s new guideline focuses on three agents for long-term obesity treatment in adults: liraglutide, semaglutide, and tirzepatide.
In the United States, many of these medicines were first approved for type 2 diabetes. Some now also have a specific, higher-dose version approved for chronic weight management. Others remain approved only for diabetes, which means using them for weight alone would be considered “off-label” and requires careful discussion of risks, benefits, and regulatory status.
Who might be a candidate for GLP-1 therapy?
According to WHO, GLP-1 therapies may be considered as a long-term option for adults with obesity, usually when lifestyle changes alone have not been enough and when there are weight-related health concerns.
At Texas Diabetes & Endocrinology, our team typically considers a GLP-1 (or related incretin medication) when one or more of the following are present:
- Type 2 diabetes that is not at goal despite lifestyle steps and other medications
- Overweight or obesity with health complications such as high blood pressure, high cholesterol, sleep apnea, fatty liver disease, or joint problems
- A history of cardiovascular disease where weight loss and improved metabolic health could lower future risk
We also carefully review situations where these medications may not be appropriate, such as a history of certain thyroid cancers, pancreatitis, or significant gastrointestinal disease.
Because GLP-1 medicines can be expensive and access is uneven worldwide, WHO also emphasizes the importance of fair access and thoughtful prescribing to avoid widening health inequities.
What shared decision-making looks like in our clinics
The new guideline reinforces something we already believe strongly: obesity and diabetes treatment should be based on shared decision-making between you and your care team, not one-size-fits-all rules.
In practical terms, that means your visit might include:
- Clarifying your goals: we’ll talk about what matters most to you – blood sugar control, weight loss, reducing medication burden, protecting your heart and kidneys, or improving energy and mobility.
- Reviewing your health history and labs: your endocrinologist will look at your A1c, kidney and liver function, blood pressure, cholesterol, other medications, and any past issues that might affect safety.
- Discussing benefits and possible side effects: we’ll cover what typical weight-loss and A1c changes look like over time, as well as common side effects (like nausea, vomiting, or constipation) and how we can manage them together.
- Considering alternatives and combinations: GLP-1 therapies are one tool, not the only tool. We may combine them with other diabetes medications, nutritional counseling, physical activity plans, or, in some cases, bariatric surgery referrals.
- Talking about logistics and cost: We’ll review dosing (weekly injections vs. daily, potential oral options), how to store and use the medication, and what your insurance may or may not cover.
- Making a plan and following up: If we decide together to start a GLP-1, we’ll schedule follow-up to monitor blood sugar, weight, side effects, and overall health, and adjust the plan as needed.
Questions to ask your endocrinologist about GLP-1 therapies
If you’re curious about whether a GLP-1 medicine might be right for you, bringing a short question list to your visit can be helpful. Here’s a list of questions that might help you:
- Based on my health history, am I a candidate for a GLP-1 medication?
- Is this medicine indicated for diabetes, obesity, or both in my situation?
- How might it affect my blood sugar, weight, blood pressure, or cholesterol?
- What side effects should I watch for, and how can we manage them?
- How long would we plan to stay on this medication if it works well?
- What happens if I stop the medication—will weight likely come back?
- How will this interact with my current diabetes drugs or insulin?
- What nutrition, physical activity, and behavioral support will I receive alongside the medication?
- Are there other options we should consider if this isn’t right for me?
How Texas Diabetes & Endocrinology Can Help
If you’d like to schedule an appointment with one of our specialists at Texas Diabetes & Endocrinology and discover how our diabetes services and other endocrinology therapies can help you lead a full and active life, please contact us at (512) 458-8400 or request an appointment online. Don’t forget to follow us on Facebook and Instagram and check back each month as we provide you with helpful health and wellness information.
This article is for educational purposes only and does not replace medical advice from your healthcare provider.
