Pharmacologic treatment of obesity has seen remarkable advances in recent years, particularly with the advent of GLP-1 receptor agonists. However, specialists gathered at the 2026 International Congress on Obesity (ICO) agreed that significant gaps remain in prevention, equitable access to therapies, and the evaluation of public policies already in place.

During the opening ceremony of the congress, held in Mexico City, Mexico, speakers emphasized the importance of developing a comprehensive model for obesity care — one that integrates both prevention and treatment measures to address obesity as a complex problem with biological, environmental, and social determinants.

José Moya, the Pan American Health Organization representative in Mexico, said reducing obesity requires transforming the environments that shape diet, physical activity, and health.

Mexico’s secretary of health, David Kersenobich, said the World Health Organization (WHO)-backed Acceleration Plan to Stop Obesity is an important driver of the country’s efforts to tackle the disease through coordinated policy measures.

Progress

Francesca Celletti, MD, PhD, senior advisor on obesity in the Department of Nutrition and Food Safety at the WHO, said the organization designed the plan in 2022 to help countries implement measures to prevent and reduce obesity, while also monitoring progress toward national goals.

She said the plan now includes 34 countries, covering 1.3 billion people — about one third of the global population living with obesity. Those countries, including Mexico, have received WHO guidance on strengthening their capacity to address the disease.

These measures range from prevention strategies — including the promotion of healthy eating, physical activity, and regulatory policies such as front-of-package labeling — to treatment and care for people already living with obesity, including efforts to close gaps in access to pharmacologic therapies such as GLP-1 agonists.

“The goal should not be simply to prevent or lower a high body mass index,” she said. “It is also to improve metabolic health, reduce mortality, and enhance people’s quality of life.”

Celletti also stressed the importance of creating healthier environments through regulatory policies such as front-of-package labeling, while at the same time caring for people already living with obesity through a multimodal model. That model includes lifestyle changes such as a balanced diet and physical activity, access to GLP-1 therapies and bariatric interventions, management of comorbidities, and ongoing support from healthcare professionals.

“In recent years, we have seen extraordinary changes — not only because of the emergence of new pharmacologic treatments for obesity but also because we now have a much better understanding of its complexity,” she said. “This new understanding should improve the way we prevent the disease, detect it, treat it, and ensure that people can access the care they need.”

She highlighted that countries adopting the acceleration plan have shown a firm commitment to prevention policies, citing Mexico and Chile, which have promoted front-of-package nutrition labeling to reduce consumption of ultraprocessed foods. Argentina and Peru have adopted similar labeling policies.

Simón Barquera, MD, PhD, director of the Center for Research in Nutrition and Health at Mexico’s National Institute of Public Health (Instituto Nacional de Salud Pública) and president of the World Obesity Federation, highlighted Mexico’s work in developing the 2025-2030 Acceleration Plan to Stop Obesity, which aims to curb the rise in obesity by 2030.

Remaining Gaps

Celletti said GLP-1 agonists represent a major advance in obesity management but cautioned that access must expand beyond those who can afford them, because their cost remains a major barrier to equitable care.

“We can’t continue to rely on fragmented responses,” she said. “We must move toward a comprehensive obesity management system that integrates prevention, primary care, treatment, public policy, and social protection.”

Barquera said governments play a crucial role in creating healthy environments, adding that food labeling and nutrition information policies are essential to building healthier food systems. He said both economic policy and broader social conditions shape food systems and obesity outcomes and pointed to Mexico’s front-of-package labeling rules and its ban on the sale of ultraprocessed foods in schools.

Barquera said that in Mexico, the prevalence of obesity among adult women rose from 17% in 1988 to 40% today. He linked that increase in part to trade liberalization with the US in the early 1990s, which he said was associated with greater availability and consumption of processed foods. He added that the trend reflects the broader role of food policy in shaping food systems.

According to Mexico’s National Health and Nutrition Survey (ENSANUT) Continua 2020-2023, the prevalence of obesity among adults was 37.1% (41.0% in women and 33.0% in men).

Roopa Mehta, MD, PhD, an endocrinologist and researcher at the Salvador Zubirán National Institute of Medical Sciences and Nutrition (Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán), said the prevalence of overweight and obesity in both Mexico and Latin America — where 67.5% of adults and 37.6% of children and adolescents aged 5-19 years are overweight or obese — represents a major public health problem because of the many associated comorbidities.

She said obesity cannot be prevented through diet and physical activity alone and that public policies are also essential. She added that mechanisms to evaluate the effectiveness of current strategies are still lacking.

Moya, Celletti, Kersenobich, Barquera, and Mehta disclosed no relevant financial relationships. 

This story was translated from Medscape’s Spanish edition.