Don't Pin All Your Hopes On Weight Loss Drugs: Here's Why

Weight loss is a topic that never seems to leave the spotlight, from trendy keto diets to the latest juice cleanses. But now, weight-loss drugs like Ozempic and Wegovy are dominating the conversation.

Globally, the weight-loss drug market was valued at $13 billion in 2023, according to the IMARC Group. In India, obesity rates have climbed over 30% in the last decade, making us a big target market for these so-called miracle drugs.

But are they a real solution—or just another expensive quick fix?

First, let’s get some context. Obesity in India is rising rapidly. According to the World Health Organization, nearly 40% of Indian adults are overweight or obese. 'Overweight' is defined as having a BMI of 25 or more, and 'obesity' begins at a BMI of 30 or higher. The National Family Health Survey V (2019-21) also found that 22.9% of men were overweight, an increase of 4 percentage points from the previous survey.

India is also facing a diabetes epidemic. A study published in The Lancet estimated that 101 million Indians (which is 11.4% of the population) live with diabetes. According to the Indian Council of Medical Research’s INDIAB study, 77 million individuals aged 18 and above are affected by Type 2 diabetes, with 25 million identified as prediabetic. These figures are expected to rise to 134 million by 2045, according to the International Diabetes Federation.

Besides diabetes, obesity is a major risk factor for hypertension and heart disease, creating what can only be described as a national health crisis.

The weight management market in India is booming. According to IMARC Group, this market was valued at approximately Rs 1.73 lakh crore in 2023 and is projected to reach Rs 3.99 lakh crore by 2032, growing at a compound annual growth rate of 9.3%. The largest revenue-generating segment is dietary products, particularly weight-loss powders.

Existing solutions, like lifestyle changes or bariatric surgery, have had limited success in addressing obesity at scale. Drugs like metformin and liraglutide offer some benefits, but have not been enough to stem the crisis.

Enter weight-loss drugs like Ozempic, Wegovy, and Mounjaro. Shikha Sharma, Founder of OneHealth, explains, "Ozempic and similar drugs were originally designed for diabetes, but they started being used for weight loss due to their effect on reducing weight."

How do they work? These drugs mimic a hormone called GLP-1, which slows digestion and makes you feel full for longer. According to studies by Novo Nordisk, some users report losing up to 15% of their body weight while on these medications.

While the results are impressive, the side effects and limitations are hard to ignore. In India, semaglutide injections cost around Rs 10,000 per month. For many, this is far from affordable.

Secondly, stopping the medication often leads to the weight bouncing back. As Sharma highlights, "Within a couple of weeks of stopping the medication, there is usually a rebound in weight as the body resets itself. Artificially induced weight loss often leads to a pendulum effect, with weight bouncing back, sometimes even more than before."

Common side effects include nausea, diarrhoea, and vomiting. Novo Nordisk studies also cite a potential risk of thyroid cancer in rare cases. Sharma adds, "One of the side effects can be an adverse effect on the liver, which impacts metabolism. Skin changes like pigmentation and texture issues are related to liver effects caused by such drugs."

When these drugs are taken without proper medical supervision, the risks increase. "Taking these drugs without supervision is a huge health risk, especially if the prescribing doctor is outside the country and unavailable for follow-up," Sharma warns.

The effects of rapid weight loss on the body and overall appearance has also been highlighted, leading to conditions known as an 'Ozempic face'. The sudden facial fat loss can give the user's skin a sagging appearance, and make it look hollow and older than the person is.

As pharma giants like Novo Nordisk and Eli Lilly race to introduce these drugs in India, affordability, accessibility, and awareness remain significant hurdles. Local pharmaceutical companies are also developing their own versions of GLP-1 receptor agonists, which could potentially bring down costs.

However, there is growing concern about misuse. Sharma notes that when taken by non-diabetics, these drugs can block pathways and lead to gastrointestinal issues and changes in gut bacteria, affecting nutrient absorption.

Obesity is a complex issue. Sharma points out the multifactorial nature of the disorder, and how it is "influenced by genetic makeup, lifestyle, food choices, and psychological factors. It cannot be cured with a pill; it requires a multi-pronged approach addressing diet, activity levels, and psychological factors like stress and binge eating." She further explains that often, obesity isn't even about eating too much, but eating the wrong types of food, which can cause the body to store fat due to nutrient starvation.

While weight-loss drugs may become more accessible in the coming years, they are not a silver bullet. "The long-term effects on behaviour, mood, and emotions are not yet fully studied, especially for non-diabetic users," she adds.

Weight-loss drugs may offer a temporary solution—but they are not the ultimate answer. Without addressing the root causes of obesity, we risk creating a dependency on costly medications with uncertain long-term outcomes.

Before we pin all our hopes on a needle, let’s remember: in a country where many are already struggling with rising healthcare costs, turning to expensive medications as the solution is simply not sustainable.