Global study suggests universal GLP-1 access could halve obesity rates and save millions of lives in five years

Key Takeaways:

• Universal access to GLP-1 receptor agonists could reduce global obesity prevalence by around 52%, potentially improving the health of more than half a billion people.
• A large-scale microsimulation study estimated that such access could prevent approximately 37.5 million deaths over a five-year period by lowering all-cause mortality by nearly 7%.
• Researchers hope these findings will encourage international policy efforts to improve availability and affordability of GLP-1 treatments.
  

Ambitious modelling seeks to quantify global impact

Universal access to GLP-1 receptor agonists (GLP-1RAs) for eligible people could dramatically cut global obesity rates by half and save tens of millions of lives over just five years, according to new research presented by Elizabeth Staton, a doctoral candidate at Emory University’s Rollins School of Public Health.

“There has been a lot of interest in GLP-1s and how they seem so effective and widely beneficial, but it wasn’t yet quantified what would be that impact on a global level,” Staton told Healio. “We found a probability study … [but] it wasn’t very rigorous.”

Seeking to close this gap, Staton and her team constructed a detailed microsimulation model to predict the worldwide effect of offering GLP-1 therapies such as semaglutide (marketed as Ozempic, Wegovy and Rybelsus by Novo Nordisk) to all eligible individuals. Their work was unveiled during a presentation at a major conference.

The GEM model – a vast global microsimulation

Staton developed what she termed the GEM model (Global Epidemiology Multimorbidity microsimulation model), building on the established Bravo diabetes model created by her colleague Hui Shao, PhD, at the Emory Global Diabetes Research Center.

“I work in a research group in the Emory Global Diabetes Research Center with Hui Shao, PhD, who has a very well-validated Bravo model of diabetes complications. Stemming from that, I’ve created a global epidemiology multimorbidity microsimulation model, which we call the GEM model. This uses peer-reviewed studies for risk ratios, … So then our estimates are slightly more rigorous,” Staton explained.

The study encompassed a synthetic population of roughly 6.57 billion individuals aged 12 years and older, using detailed health data from the 2021 Global Burden of Disease and Non-Communicable Disease Risk Factor Collaboration studies. Eligibility for treatment was defined as having obesity and being at least 12 years old, or having type 2 diabetes with overweight and being at least 18 years old.

“Because it’s a microsimulation, we have individual level data, so we can just subset into people who would fit in the cohort studies. Then we compare our estimates that are predicted vs. the actual cohort studies,” Staton said.

The researchers validated their model by comparing it with prospective cohort studies and existing probability models to ensure robust estimates.

Striking findings on obesity and mortality

The results were remarkable. Staton and colleagues estimated that more than 1 billion people worldwide meet the criteria for semaglutide treatment. Under a scenario of universal access:

• Global obesity prevalence would decline by approximately 52%, an absolute reduction of about 9 percentage points, potentially improving the lives of around 565 million people.
• All-cause mortality would fall by nearly 7%, an absolute reduction of 0.6 percentage points, preventing an estimated 37.5 million deaths within five years.
  

“The compelling finding is that obesity would be reduced by almost 50% [and] mortality reduced by about 7% globally. These are hugely impactful [estimations] in just a 5-year time horizon,” Staton emphasised.

Hopes for policy and pricing changes

Staton hopes that these findings will help spur global efforts to expand access to GLP-1 therapies. “I hope these data move the conversation about global access forward. There are a number of reasons why access to GLP-1s are limited, with costs, supply and access to providers who prescribe them,” she told Healio.

Ultimately, she hopes that evidence of such a substantial potential benefit might encourage policymakers, manufacturers and global health agencies to invest more heavily in reducing drug costs and expanding prescribing infrastructure.

A tool for thought – not an immediate roadmap

Despite the eye-catching figures, Staton cautioned that this microsimulation is not intended as a direct prediction of what will happen. “The joy of microsimulation is that it’s not really a realistic scenario, but it’s an interesting one to explore,” she said.

Even so, the research underscores the scale of potential benefits if barriers to GLP-1 access could be overcome – offering a powerful data-driven argument for rethinking the global approach to obesity and metabolic disease treatment.

CCH Insight:

The potential benefits of GLP-1 receptor agonists and other, similar, anti-obesity medications are indeed huge, and possibly much greater than predicted in this study, due to the wide-ranging impact of these medicines. Not only do they treat obesity, they also improve glycaemic control and reduce cardiovascular disease risk, and may also protect against liver disease, kidney disease and neurodegenerative diseases like Parkinson’s and dementia.