WHO Recommends GLP-1 Medications for Obesity, Access Challenges Persist

The World Health Organization (WHO) has conditionally endorsed the use of GLP-1 medications, such as Ozempic, for the treatment of obesity. This recommendation, issued on December 4, 2023, marks a significant shift in the approach to managing obesity, yet many residents of Prince Edward Island (P.E.I.) may find it difficult to access these treatments.

The new guidelines are the first from the WHO that specifically address the use of GLP-1 agonists as part of long-term obesity management. These medications, which were previously designated for type 2 diabetes, have been shown to be both safe and effective in long-term studies. According to Kara Evers, a nurse practitioner and co-ordinator at the Halifax Obesity and Bariatric Surgery Clinic, this development underscores the importance of recognizing obesity as a chronic disease.

Evers stated, “It continues to shine a light on obesity as a chronic disease. One in three Canadians are currently living with obesity, and that number is expected to rise to about 50 percent in the next decade.” She emphasized that this is an opportune moment for policymakers to take decisive action.

Access Issues for Islanders

Despite the WHO’s supportive stance, Evers expressed concern over access barriers for many Islanders and Canadians at large. Currently, only about 20 percent of Canadians can obtain GLP-1 medications through their insurance plans. In many provinces, including those in Atlantic Canada, provincial Pharmacare programs do not cover these drugs for obesity treatment, as obesity has not yet been recognized as a chronic disease.

Evers noted, “We are advocating within Canada for coverage of these medications. Obesity Canada is leading that charge, and hopefully, the WHO’s declaration will strengthen our efforts to ensure these treatments are recognized and made accessible.”

The Department of Health and Wellness in P.E.I. confirmed that GLP-1 drugs are not covered under provincial drug programs for weight loss. Currently, only Ozempic and Rybelsus are listed for type 2 diabetes treatment, which requires special authorization. The department acknowledged the need for a review process to include GLP-1 medications for weight loss as the recognition of obesity as a chronic disease evolves.

Potential Benefits for Surgery Preparation

GLP-1 drugs may also play a crucial role in preparing patients for bariatric surgery, which involves reducing stomach size to assist with weight management. Evers highlighted that patients experience long wait times for access to obesity care and surgical options in the Atlantic provinces, with P.E.I. notably lacking an established bariatric surgery program.

Evers pointed out, “Sometimes we have individuals with higher body mass index (BMI) levels who require GLP-1 medications to meet surgical safety parameters. These medications can make a significant difference in whether a patient qualifies for surgery.”

Changing Perceptions of Obesity Treatment

There is a pressing need for education to address the stigma surrounding obesity and its treatment. Evers argues for a shift in terminology, urging people to refer to GLP-1 medications as “obesity medications” rather than “weight-loss medications.” She explained that this terminology provides an accurate medical context and helps combat the negative perceptions associated with such treatments.

The conversation around obesity has been polarized, often influenced by societal pressures and stigma. Evers noted the criticism faced by public figures who have undergone weight changes, linking their transformations to GLP-1 drugs. “There’s no more polarizing topic than weight, and particularly women’s weight. We need to acknowledge that these individuals are living with a disease and seeking treatment, which should not carry any shame,” she said.

As the WHO’s endorsement of GLP-1 medications opens new avenues for obesity treatment, the focus now shifts to ensuring that these resources are accessible to those who need them the most. Evers and other advocates continue to push for necessary policy changes to support individuals living with obesity, fostering an environment where treatment is both effective and available.