India's Obesity Crisis: New Drugs Offer Hope Amid Risks
Weight loss is no longer just a fad related to appearance or beauty, nor is it limited to the desire to look like a ‘size zero’. It has become a much more serious and comprehensive subject than that. It is now an essential effort towards good health and reducing unnecessary and harmful fat from the body. It is about preventing or delaying the onset of diabetes and other related problems. So the question now arises, what should one do? Put aside the weighing scale that repeatedly refuses to show the desired number? Or keep climbing it and getting down in disappointment every time? It is true that a large number of people in India are struggling with obesity. They try their best to lose weight, but most of the attempts fail.
The obesity rate among women in India increased from 1.2% in 1990 to 9.8% in 2022. This rate increased from 0.5% to 5.4% in men. According to a Lancet study report, the obesity situation in India is alarming, with about 70% of the urban population being overweight. Globally, India ranks third after the US and China.
According to data from the National Family Health Survey, more than 24% of women and 23% of men in India fall in the overweight or obese category. Obesity is far more prevalent in urban areas than in rural areas, especially among women. Obesity is a major risk factor for many serious diseases such as diabetes and heart diseases. Now the question arises, what is obesity and how is it measured? According to the World Health Organization, if a person's body mass index, which is an approximate measure of body fat, is 30 or more, then he is classified as obese. The body mass index is calculated based on the height and weight of the person.
There is evidence that Monjaro not only controls blood sugar levels but also reduces appetite, leading to weight loss. Another important drug is Semaglutide, which is known by different names internationally and has recently been made available in India. These drugs are being discussed in the medical field and are being described by leading endocrinologists in the country, such as Dr. Ambrish Mittal, as useful for diabetes and weight control.
Dr. Mittal has also written a book on weight management through these drugs, in which he has mentioned in detail their benefits as well as potential harms. He clearly warns that these drugs should be taken only under the supervision of a doctor and not just out of convenience or attraction. These drugs have both types of effects, some beneficial, while some potentially harmful. These new generation drugs reduce appetite drastically and help patients adopt the necessary dietary changes without feeling hungry again and again but there are side effects associated with them. Most prominently loss of muscle mass and regain of weight after stopping the drug. If asked Dr Mittal, he says that whenever weight is lost, some amount of muscle mass is also lost.
When someone sheds 15 kg, they might lose around 4 kg of muscle, which is too much. He stated, 'The issue occurs when you lose weight and it returns. What comes back is just fat, and muscle mass does not regenerate.' If a person goes through this cycle three times, there is excessive loss of muscle mass and fat is accumulated again. Hence strength building exercises and adequate protein intake are a must. However, there is some hope attached to these drugs. Research is underway on muscle-preserving drugs and if successful, it could be a game-changer for the entire treatment system. Yet, despite this drawback, the benefits of these drugs far outweigh their potential risks. Reports indicate that in the near future, many such drugs will be available that will not be as complex or impactful on the body and will also be easy to use.
Yet the worrying aspect is that they also have some side effects. Nausea, digestive problems, constipation, gallstones and diarrhea. The warning is that they should only be used under the supervision of a qualified doctor. Also, these drugs are not suitable for people who have a history of thyroid cancer or pancreatitis. Another serious thing is that these drugs do not work equally on everyone, some people do not get the desired weight loss. Using them alone or by people who do not really need these drugs, if they are taking them just for show and then stopping them arbitrarily, then it can prove to be very harmful.
Another downside is that as soon as these drugs are stopped, there is a possibility of weight gain again. In simple words, these drugs are effective only as long as they are taken regularly. Weight can increase again as soon as they are stopped. Moreover, this is not a limited treatment of three months. Experts believe that a person who starts taking these drugs has to take them regularly for at least one to two years, and in some cases it can also become a lifelong medication. So even though these drugs are taken with caution, there is a possibility of weight gain again. While there is a lot of excitement and buzz, it is important to understand that these are not ‘magic drugs’ to be taken just to achieve ‘size zero’. They should be taken only when prescribed by a doctor and not just because one wants to lose weight or look better. Measures such as diet, exercise and lifestyle modifications are much safer and effective for such goals.