A new study published in Nature has mapped the “velocity” of obesity across 200 countries, suggesting that gaps in treatment access may be worsening outcomes in some of the hardest-hit regions.
The research, led by Majid Ezzati of Imperial College London, tracked height and weight data from 232 million people between 1980 and 2024. The findings show that obesity rates are plateauing or declining across many wealthy Western nations, while rising faster than at any point in the past 45 years across Latin America, sub-Saharan Africa, South and Southeast Asia, and Pacific Island nations.
Together, the data points to a growing disconnect between where obesity is accelerating fastest and where the industry’s blockbuster treatments are actually available.
Imbalanced market dynamics
While the GLP-1 drug market is currently worth around $8bn annually, it is projected to reach $65bn by 2035. Yet access remains heavily concentrated in North America and Europe, the same regions where obesity rates are levelling off. As a result, J.P. Morgan estimates global GLP-1 penetration at roughly 2% of the obese population, underlining how limited access remains worldwide.
In a statement published by Imperial College London, Ezzati was direct in his message to the pharmaceutical industry. “The focus should be on making [GLP-1 drugs] more affordable to all who need them around the world,” he said, adding that population-level data showed no clear sign that the drugs themselves had driven the plateau seen in wealthier nations.
Potential solutions
The study arrives ahead of what could become a major turning point for access. In 2026, semaglutide patents are due to expire in Brazil, China, India and Turkey, countries that together account for around 40% of the global population. Once those patents lapse, generic injectable semaglutide could reportedly be produced for as little as $28 per person per year, potentially opening access for lower-income healthcare systems.
Nevertheless, cold-chain requirements may still limit widespread GLP-1 deployment across much of the developing world. That has shifted attention toward oral formulations, which could remove one of the biggest logistical barriers beyond cost alone. Both Novo Nordisk and Eli Lilly have launched oral versions of their weight-loss treatments in recent months, signalling a broader push to expand accessibility.
WHO verdict
Whichever approach gains traction, the study has reinforced the scale of the global imbalance, one that the WHO has described as “a profound equity dilemma that lies at the very heart of global public health”.
