The World Health Organisation’s (WHO) new guideline on Glucagon-Like Peptide-1 (GLP-1) medicines signals a significant shift in how we manage obesity globally. According to the WHO, the guideline calls on the global community to consider strategies to expand access, such as pooled procurement, tiered pricing, and voluntary licensing. While the guideline does not explicitly insist on classifying obesity as a distinct disease, the question naturally arises — should it be?
GLP-1 medicines address appetite, cravings, and metabolism, and can significantly help appropriate patients as potent tools for obesity care. But unless India formally recognises obesity as a chronic disease, access, affordability, and standard prescribing guidelines will remain inconsistent, experts advocate.
Calling the new WHO guidance on GLP-1 medicines “a landmark moment”, Dr Rajiv Kovil, Head of Diabetology and a weight-loss expert at Zandra Healthcare, and Co-founder of Rang De Neela Initiative, urged that India must first recognise obesity as a disease, not a lifestyle flaw. “Without this fundamental shift, policies, insurance coverage, and access to modern treatments will remain fragmented,” said Dr Kovil.
As a clinical dietician and diabetes educator helping people manage obesity for the last 17 years, Kanikka Malhotra too said that recognising obesity as a chronic health condition does help create stronger systems of care: it leads to structured screening, long-term support, insurance coverage, and access to evidence-based treatments. “It moves obesity away from a blame-based narrative and into a medically supported one,” said Malhotra.
Why hasn’t India officially classified obesity as a disease?
Although a national expert panel is currently drafting India’s first formal obesity guidelines, the condition still lacks official disease status in the country.
The hesitation stems from long-standing cultural beliefs that weight gain is solely a behavioural issue. Policy development has not kept pace with progress in metabolic science, rued Dr Pranav Ghody, consultant endocrinologist and diabetologist at Wockhardt Hospitals, Mumbai Central.
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There are also worries about healthcare costs if millions of Indians suddenly fall under a “disease” category, which has left obesity in a policy grey area, pointed out Dr Ghody.
Understanding obesity and the need for classification for the patients and the systems
From an endocrinology perspective, obesity is primarily a hormonal and metabolic disorder. “Appetite regulation, insulin sensitivity, fat storage, and energy expenditure are all controlled by complex endocrine pathways,” said Dr Ghody.
When we label obesity as a disease, it shifts the focus to these biological factors instead of treating patients as if they lack discipline, as described by Dr Ghody. Recognising it as a disease legitimises medical care, encourages early diagnosis, reduces stigma, and “brings India in line with global scientific consensus on metabolic health”.
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Why experts advocate for obesity to be officially recognised as a disease (Photo: Getty Images/Thinkstock)
Obesity fuels more than 240 medical disorders, from diabetes to heart disease, and 13 types of cancers. Directly classifying it as a disease will drive national registries, formal screening programs, rational pricing, and public-health reforms, said Dr Kovil. “The terminology matters because recognition shapes policy. When we name it correctly, we can finally treat it correctly and ensure therapies like GLP-1s reach the people who need them most,” explained Dr Kovil, who runs United Diabetes Fronts ROAD (Recognising Obesity as a Disorder/Disease) project to sensitise everyone about the need for this move.
“Classification is the first step to safe, regulated and equitable use of these therapies,” reiterated Dr Prashant Hansraj Salvi, chief bariatric and metabolic surgeon, consultant minimal invasive, bariatric and metabolic surgery, Jupiter Hospital, Thane.
Without classification, it becomes challenging to streamline early identification, strengthen national data collection, update medical education, or create insurance pathways that support treatment, noted Dr Ghody.
A formal classification helps create structure. Endocrinologists already follow defined pathways for diabetes and thyroid disorders; obesity deserves the same, Dr Ghody asserted. “Disease status allows for routine screening, standardised treatment plans, long-term monitoring, and the possibility of insurance coverage. Most importantly, it reduces stigma so patients seek help sooner, before complications like diabetes, PCOS, fatty liver, and hypertension arise,” he described.
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Calling obesity a chronic metabolic disease, rather than a lifestyle issue, alters how clinicians prioritise it, how systems fund it, and how patients understand it. “Language affects behaviour, and in medicine, behaviour determines outcomes,” expressed Dr Ghody.
Issues with not recognising obesity as a disease
Stigma, delayed care, and lack of insurance support are the most significant barriers, experts highlighted. “Many people approach us only after years of struggling alone, often when they already have diabetes, sleep apnoea, or fatty liver. Those in the BMI 30–35 category suffer significantly but are not eligible for treatment coverage, leading to late intervention,” said Dr Salvi.
Dr Ghody highlighted how many patients only see endocrinologists after developing diabetes or other metabolic issues. “Early screening in primary care is still weak, and obesity has not been integrated into routine metabolic health practices across the country,” said Dr Ghody.
Dr Salvi said insurance covers only those with a BMI of 35–40 for surgery, but a massive group of people fall in the 30–35 BMI range and are already dealing with diabetes, cholesterol issues, fatty liver, and several metabolic problems.
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“Because obesity is not officially classified as a disease in India, these individuals are not considered eligible for treatment coverage — even though their health risks are very real. Insurance currently does not cover obesity-related medications either, which makes long-term management even harder for patients,” elucidated Dr Salvi.
This gap shows how urgently insurance criteria need to evolve. Early recognition would allow timely intervention, preventing patients from reaching severe stages where the BMI crosses 40 and the condition becomes far more challenging to manage, said Dr Salvi. “The hesitation so far has come from old beliefs that weight is a personal choice and concerns about rising healthcare costs, but the ground reality shows that delaying recognition only increases the burden later,” said Dr Salvi.
In fact, even if all 12 GLP-1 medicines scale to their maximum global capacity, they will reach barely 10 per cent of the 800–900 million people living with obesity, pointed out Dr Kovil. “The remaining 90 per cent will depend not on medication, but on prevention, which is better nutrition, compulsory food education in schools, and stronger public-health literacy. This is why recognising obesity as a disease or disorder is the true turning point,” said Dr Kovil.
How does it help when obesity is formally classified as a disease
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Obesity affects people in every country. According to the WHO, it was associated with 3.7 million deaths worldwide in 2024. “Without decisive action, the number of people with obesity is projected to double by 2030,” it reads in its latest guideline.
According to Dr Kovil, once we classify it correctly, we can fix everything upstream: inaccurate food-labelling practices, unregulated marketing, the pricing imbalance where sugary beverages are cheaper than healthy foods, and the poor availability of nutritious options.
Experts urge that official recognition helps to streamline processes, prevention (Photo: Freepik)
“A disease classification empowers policymakers to redesign taxation, improve the affordability of healthier food, mandate clearer labels, and build a culture that protects children and families. GLP-1s are a breakthrough, but only a small part of the solution. System-wide reform begins the moment we acknowledge that obesity is not a failure of willpower and that it is a medical disorder that demands a structured national response,” said Dr Kovil.
Obesity is a chronic condition, not a personal failure, said Dr Salvi. “Long-term results come from a combination of lifestyle changes, medicines, and continuous follow-up. Early intervention prevents the disease from progressing to a stage where aggressive treatment becomes the only option,” said Dr Salvi.
Does such classification stigmatise people living with it?
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How about the emotional weight the word “disease” carries? For many people, it feels harsh, heavy, and stigmatising — as if their body is being labelled, not their health state. “So yes, we need the seriousness that formal recognition brings, but we also need a gentler, more empowering vocabulary,” expressed Malhotra. Instead of framing obesity as a ‘disease people have’, we can frame it as a chronic, modifiable condition people can manage. The science stays the same — we still treat it proactively, systematically, and compassionately — but the language shifts from judgement to hope,” Malhotra shared.
Recognising obesity as a disease does not stigmatise people; it actually humanises them. “Just as we say ‘people with diabetes,’ we must say ‘people with obesity,’ not ‘obese.’ This language builds empathy and shifts the narrative from blame and willpower to science and support. Classification brings dignity, understanding, and better care,” said Dr Kovil.
Do labels really matter? Does calling it a disease make a real difference?
Yes, affirmed Dr Salvi. “Disease recognition leads to structured treatment pathways, insurance support, clinician training, and earlier diagnosis. Patients understand the condition better, families take it seriously, and care becomes standardised rather than dependent on who can pay out of pocket.”
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In public health and in clinical practice, terms matter. Not because they change the biology, but because they shape how people feel about seeking support. “If we truly want better outcomes, we need both: the clinical clarity of recognising obesity as a long-term health condition, a disease, and the positive, human-centred narrative that helps people engage with care without shame,” said Malhotra.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
