Obesity is growing rapidly and contributing to serious and life-altering noncommunicable conditions, including diabetes, cardiovascular diseases, and some types of cancer. Historically, public health strategies to prevent and manage obesity have focused on behavioral and policy interventions promoting healthier lifestyles and discouraging the consumption of unhealthy foods. More recently, anti-obesity medicines (AOMs) have emerged as a valuable addition to the treatment toolkit, offering the added benefit of addressing related comorbidities. With some AOMs losing exclusivity and growing recognition of their public health value, supported by expanding clinical and real-world evidence and their inclusion in essential medicines lists (EMLs), their introduction and broader use in low- and middle-income countries (LMICs) could be transformative.

This white paper explores the implications of introducing AOMs in LMICs, focusing on:

• The current state of obesity as a public health threat in vulnerable regions.
• The opportunities and challenges these therapies present for prevention and treatment.
• The potential impact that affordable AOMs at scale—led by but not limited to off-patent semaglutide—could generate in LMICs.
• Strategic pathways for governments, life sciences companies, and multilateral organizations to improve access and health system readiness.

The paper concludes with a reflection on the value of using real-world data, especially through obesity registries, to encourage more inclusive clinical research, evaluate the success and sustainability of treatment, and support the refinement of policies and other public interventions.