Washington, DC, March 3, 2026 (PAHO) — The Pan American Health Organization (PAHO) urged countries in the Region of the Americas to strengthen monitoring and ensure the appropriate use of glucagon-like peptide-1 receptor agonist (GLP-1) medicines, in light of increasing reports of adverse events associated with their misuse.
In an epidemiological alert published on February 27, 2026, PAHO noted that in recent months several countries have reported adverse events of varying severity linked to the use of these medicines—such as semaglutide, dulaglutide, liraglutide, tirzepatide, among others—which are indicated for the treatment of type 2 diabetes under specific criteria and, in some cases, for obesity.
Obesity is recognized as a chronic disease that requires a comprehensive and sustained approach. In this context, PAHO underscores that the use of pharmacological interventions should be carefully assessed within multidisciplinary, person-centered care models, considering the individual clinical profile, comorbidities, and the benefit-risk balance of each therapeutic option.
GLP-1 medicines work by regulating appetite and metabolism, but their use should be limited to approved indications and implemented within a structured clinical plan with periodic monitoring. WHO has issued global guidance on their appropriate and supervised use, based on the latest scientific evidence.
In February 2026, the WHO Expert Committee on the Selection and Use of Essential Medicines supported the publication of the 24th edition of the Model List of Essential Medicines, which recommends including semaglutide, dulaglutide, liraglutide, and tirzepatide as additional therapies for adults with type 2 diabetes and established cardiovascular or chronic kidney disease who also have obesity (BMI ≥30 kg/m²). The Committee did not recommend the use of these products in people with obesity without type 2 diabetes or other comorbidities.
The most frequently reported adverse events are gastrointestinal and usually temporary. Less frequent, but potentially serious, events have been reported, including acute pancreatitis, gallbladder disease, and intestinal obstruction, as well as other rare risks that remain under evaluation.
PAHO warns that the growing demand for these medicines may encourage their commercialization through unofficial channels, including the internet and social media, increasing the risk of exposure to falsified, unauthorized, or substandard quality products. These products may contain incorrect doses, different active ingredients, or undeclared substances, which can lead to therapeutic failure, serious adverse reactions, and other complications, in addition to generating additional costs for patients and health systems.
In the Region of the Americas, several regulatory authorities have issued communications regarding off-label use and the detection of falsified or unauthorized products. PAHO cautions that using these products for exclusively aesthetic purposes, without a comprehensive clinical assessment or medical indication, may expose individuals to unnecessary risks and divert resources from those with clear medical indications.
PAHO recommends that countries:
- Ensure that the use of GLP-1 agonists is limited to indications approved by the national regulatory authority, within the context of a comprehensive, long-term management plan for obesity or diabetes, as appropriate.
- Train health personnel on risks, interactions, contraindications, and warning signs.
- Strengthen national pharmacovigilance systems to promptly detect and report adverse events, including those associated with off-label use or procurement through unauthorized channels.
- Intensify oversight of the pharmaceutical market and supply chain to prevent the circulation of substandard or falsified products.
- Develop communication strategies targeted to the public and health professionals to inform them about the risks of use without medical supervision and about official channels for reporting adverse events.
The Organization emphasizes that these medicines should be used exclusively under medical prescription and with appropriate clinical follow-up. Strengthening cooperation among national regulatory authorities and regional networks for the detection and management of emerging risks is critical.
