Integrating Modern GLP-1–Based Therapies with Traditional Lifestyle Interventions: A Public Health Review on Diabetes and Obesity Management

The global prevalence of obesity and type 2 diabetes mellitus (T2DM) has reached unprecedented levels, posing significant challenges to health systems, particularly in low- and middle-income countries. While traditional lifestyle interventions-dietary modification, physical activity, and behavioural change-remain foundational in prevention and management strategies, their long-term effectiveness has been limited by biological, social, and structural constraints. In recent years, glucagon-like peptide-1 (GLP-1) receptor agonists and dual incretin-based therapies have emerged as transformative pharmacological tools, demonstrating substantial efficacy in glycemic control, weight reduction, and cardiometabolic risk mitigation. This public health review critically examines the integration of modern GLP-1–based therapies with traditional lifestyle interventions, emphasising synergy rather than substitution. Using a qualitative methodology grounded in narrative synthesis and policy analysis, the study draws upon clinical trials, public health guidelines, and sociobehavioral research to explore effectiveness, equity, ethical considerations, and implementation challenges. A socioecological and chronic care theoretical framework is employed to contextualise obesity and diabetes as complex, multifactorial conditions requiring sustained, system-level responses. The review argues that GLP-1 therapies, when embedded within comprehensive lifestyle and public health strategies, offer a more realistic and equitable pathway for long-term disease management. However, issues of access, affordability, cultural adaptation, and health system capacity remain critical barriers. The article concludes with policy-oriented recommendations for integrating pharmacotherapy and lifestyle interventions in a manner that strengthens public health outcomes while minimising inequities. Keywords: GLP-1 receptor agonists, obesity, type 2 diabetes, lifestyle intervention, public health, qualitative review