1 in 4 Adults Worldwide Eligible for GLP-1 Treatment for Obesity, With Jennifer Manne-Goehler, MD

More than 1 in 4 adults worldwide are eligible for GLP-1 receptor agonists for obesity management, of which almost 4 in 5 live in low- or lower-middle-income countries, according to a recent study from Mass General Brigham.1

GLP-1 receptor agonists have emerged explosively into every corner of medicine, acting as an effective therapeutic class for obesity management and the prevention of its myriad complications. Global organizations, such as WHO, are actively assembling guidelines and exploring policies for the integration of obesity management medications like GLP-1s. Understanding the possible demand and socioeconomic impacts of GLP-1 receptor agonists is necessary for effectively designing these policies.2

To that end, a team of investigators from Mass General Brigham, Washington University School of Medicine, and Emory University’s Rollins School of Public Health analyzed pooled, individual patient data from a series of nationally representative, cross-sectional household health surveys, which had been conducted across 99 countries between 2008 and 2021. Of the surveyed patients, investigators collected a sample comprised of non-pregnant individuals between 25-64 years with an available diabetes biomarker, body mass index (BMI) and blood pressure measurement, and complete data on hypertension and diabetes diagnoses.1,2

“The motivation for this paper is to start quantifying the challenge of scaling and paying for GLP-1s as we think about models of care that work best,” said Jennifer Manne-Goehler, MD, a physician in the division of infectious diseases at Brigham and Women’s Hospital and the department of medicine at Mass General Brigham, in an exclusive interview with HCPLive. “What are the sustainable ways to do this? How do you take a new tool, build a system around it, and make it available to millions of people?”

Patients were defined as eligible for GLP-1 receptor agonists for weight management if they had a BMI ≥30 kg/m2 or a BMI of ≥27 kg/m2 with hypertension, diabetes, or both. Hypertension was defined based on measured blood pressure, while diabetes was defined based on glycemic markers included HbA1c and plasma glucose. Notably, obesity-related comorbidities like sleep apnea or cardiovascular disease were not considered.2

The pooled sample included a total of 810,635 patients from 99 countries. Of the utilized surveys, 15 were conducted in low-income countries, 34 in lower-middle-income countries, 30 upper-middle-income countries, and 20 in high-income countries. The median response rate was 87%, and the mean age of included respondents was 38 years (Standard Deviation [SD], 9.7). Of these respondents, 617,915 were women.2

Investigators found that roughly 27% of the pooled sample were eligible to receive GLP-1 RAs (95% CI, 26.2-27.8); when incorporating age-stratified UN 2020 population size estimates, this equates to roughly 799 million individuals. When divided by country income, eligibility was 11.7% (95% CI, 10.9-12.5) in low-income countries, 25.2% (23.6-26.8) in lower-middle-income countries, 26.2% (25-27.4) in upper-middle-income countries, and 41.8% (40.5-43.2) in high-income countries.2

Eligibility varied substantially across world regions, with the highest in Europe and North America (42.8%; 95% CI, 41.4-44.2) and the Pacific Islands (41%; 39-43.1). Although 23.1% of patients were eligible in south, east, and southeast Asia, the largest absolute number of eligible patients were located here. Additionally, women were more likely to be eligible (28.5%; 95% CI, 27.6-29.5) than men (25.5%; 95% CI, 24.6-26.4). Eligibility also increased with age, ranging from 17.9% (17-18.8) among patients 25-34 years to 38.3% (36.8-39.7) among patients aged 54-64 years.2

“With health policymaking bodies and medical societies, I think there’s an increasing focus on obesity and people with high-risk diseases under their BMI,” Manne-Goehler said. “These are the people we need to figure out how to better select from our patient panels and start offering it to them, because those are the patients with the potential for the best health benefits of using these medicines.”

Editor’s Note: Manne-Goehler reports support from the US National Heart, Lung, and Blood Institute.

References

1. Mass General Brigham. Study finds more than a quarter of adults worldwide could benefit from GLP-1 medications for weight loss. Eurekalert! January 8, 2026. Accessed January 13, 2026. https://www.eurekalert.org/news-releases/1111834

2. Yoo SG, Teufel F, Theilmann M, et al. GLP-1 receptor agonists for obesity: Eligibility across 99 countries. The Lancet Diabetes & Endocrinology. 2026;14(2):105-108. doi:10.1016/s2213-8587(25)00356-0