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AMSTERDAM — At the HLTH Europe 2025 conference, experts discussed the nuanced landscape of GLP-1 medications in Europe, revealing a complex interplay of skepticism, financial hurdles, and evolving perceptions of obesity.

While clinical evidence supporting GLP-1s is growing, European healthcare providers have not widely adopted these medications, particularly in the public sector.

According to Manuel Nothelfer, co-founder and CEO of Wellster, stringent regulations, societal stigma that still often views obesity as a “lifestyle choice” rather than a disease, and the financial burden on public health systems lead to a tendency to view GLP-1s as a “last resort” treatment. This is why there is less uptake in Europe than in the US.

Tessy Huss, director of strategy at HLTH community, added that some European countries have yet to formally classify obesity as a disease — a factor that limits access to treatment.

In the UK, where 28% of the population has obesity, the National Health Service feels primary care isn’t equipped to handle widespread GLP-1 medication distribution, explained Ro Huntriss, a registered dietitian and the chief nutrition officer at Simple App.

There is a need for more staffing, greater healthcare professional education, and the integration of digital health solutions, she said. It is also important to ensure a consistent medication supply to prevent interrupting patient treatment plans. “There is not an acceptable patient journey,” she added.

Beyond BMI: Redefining Eligibility and Benefits

As scientists continue to learn how GLP-1 medications work, it is becoming clear that the benefits go beyond mere weight loss. Studies have observed a significant reduction in cardiovascular events, an impact on inflammatory processes, and even improvements in sleep apnea and neurodegenerative diseases, according to Ihsan Almarzooqi, MD, co-founder of GluCare.Health.

These findings are prompting a reevaluation of eligibility criteria beyond BMI. “BMI alone might not be the best measure,” said Scott Honken, chief commercial officer at WeightWatchers, suggesting that a more holistic approach incorporating metabolic syndrome diagnosis would provide a “much better picture for whom should be taking these medications.”

This expanded understanding of GLP-1 benefits also contributes to the ongoing debate about their high upfront costs. While the direct cost of GLP-1s can be substantial, the broader health improvements and reduced need for other medical interventions could lead to significant long-term savings. “The curve is starting to bend around 2 or 3 years,” said Honken; that is the point at which the return on investment becomes positive due to reduced emergency room visits and other medical cost savings.

A Lifestyle Change Is Not Negotiable

However, despite these broader benefits and evolving economic arguments, the panel stressed that lifestyle interventions are nonnegotiable in obesity management. GLP-1s are a powerful tool, but they are not a standalone solution, said Huntriss. “Good diet and lifestyle can reduce blood pressure, it can reduce cholesterol, it can improve inflammation. We shouldn’t just go straight to the medication.”

She added that a critical missing element in current treatment paradigms is comprehensive, ongoing support, with a multidisciplinary approach that includes dietitians, exercise practitioners, and coaches. “If people don’t have that wrap-around support, they are less likely to adhere to treatment and achieve sustainable outcomes,” she said.

Patients need to understand that GLP-1s are part of a broader behavioral change strategy. Simply taking the medication without addressing lifestyle factors often leads to weight regain once the drug is stopped, Honken said. Moreover, even with weight loss from GLP-1s, patients need guidance to ensure they remain well-nourished, Huntriss said.

Huss reported having no relevant financial relationships.

Manuela Callari is a freelance science journalist specializing in human and planetary health. Her work has been published in The Medical Republic, Rare Disease Advisor, The Guardian, MIT Technology Review, and others.