Weight loss drugs such as semaglutide and tirazepide have seen an increase in demand, leading to a surge in sales. This growing demand has left many people wondering if these are really a magical solution to a complex problem like weight loss.
In an interview with HT Lifestyle, Dr Shobha Subramaniam-Itolikar, consultant physician at Fortis Hospital, Mulund, shared, “The impact of weight loss drugs in the Indian pharmaceutical market really impressed me when a colleague, who is a plastic surgeon, commented about this after the discovery of semaglutide, for a post-weight loss mop-up procedure, either to trim away loose abdominal skin or to tighten a fat-free chin in their The number of patients coming to the clinic has increased. In another example, a patient who came to India from the Middle East for treatment requested a prescription for tirazeptide injection even before the drug arrived on Indian shores.
“Weight loss drugs work by affecting metabolism, appetite and the way the body stores fat,” he explains. They cannot be purchased as over-the-counter medications and can only be prescribed by a medical practitioner. Most weight loss medications were prescribed to treat people with type 2 diabetes mellitus (T2DM), and weight loss was an unintended side effect. However, their real purpose has gradually been eclipsed by something more interesting, namely helping people lose weight.”
The craze for these drugs is at its peak and even people who don’t really need them (non-diabetic, non-obese people) are taking them to lose weight. “This has led to a shortage of these drugs in the market, and diabetics who really need these drugs to achieve their glycemic targets are being deprived of them,” revealed Dr Shobha Subramaniam-Itolikar. The word ‘thin’ has now become synonymous with the word ‘healthy’. The thinner you are, the healthier you are considered. Although weight loss drugs are not a recent invention, they have been available in the market for almost a century; “It started with amphetamines in the 1930s.”
Many other drugs were developed to aid in weight loss, such as orlistat, sibutramine, etc., but these drugs were not without their side effects, failure to lose weight being one of them. Dr. Shobha Subramaniam-Itolikar highlights, “Recently drug manufacturers have started focusing on the underlying etiology of ‘diabetes’ (the deadly duo of diabetes and obesity) and thus new age weight loss Medicines have come to the fore. Weight loss pills target a person’s appetite and are successful in aiding weight loss. These drugs are GLP1 receptor agonists such as exenatide, liraglutide, dulaglutide, semaglutide, and the dual GLP/GIP analog tirazeptide. Both these medicines are recent inventions that have taken the world by storm because of their promises.”
Thus, it becomes important to pay attention to the advantages and disadvantages of drugs like semaglutide, which are listed below.
Benefit:
- Helpful in weight loss.
- Better control over diabetes and its complications like diabetic neuropathy, nephropathy, heart failure.
- Improvement in metabolic parameters especially lipid profile, uric acid etc.
- Relief from complications of obesity like obstructive sleep apnea, fatty liver, arthritis.
- Restoration of self-worth and self-esteem, which can help improve one’s mental health.
Loss:
- Minor tolerable side effects such as nausea, vomiting, constipation and bloating.
- Weight loss is difficult to maintain once the drug is stopped and lost weight is likely to return if aggressive diet and lifestyle measures are not followed.
- Medications do not reduce weight in 20-50% of cases.
- Excessive costs are affecting treatment adherence and continuity.
- Relatively new medicines and hence not much is known about them.
- While the proposed risk of thyroid cancer is established by rodent studies, similar data on human subjects are not available.
- Recent reports of possible blindness due to optic neuropathy – not yet confirmed by researchers (very early reports).
- Risk of pancreatitis – rare but possible side effect.
- Contraceptive failure – Data are sparse but the possibility exists due to irregular absorption of the drug due to delayed gastric emptying.
Dr Shobha Subramanian-Itolikar concludes, “The weight loss process should ideally be completely organic i.e. clean eating, regular exercise, good sleep and reducing stress. These drugs were developed with ‘diabetes’ in mind, although they have been found to have off-label use in non-diabetic obese individuals. This type of medication-assisted weight loss should only be recommended to people who are severely obese, as these are the people who are unable to mobilize themselves to burn calories. For them this is a better alternative to bariatric surgery. Appropriate indications for its use must be defined by healthcare workers and regulatory authorities must monitor the use of these drugs.
Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Always seek the advice of your doctor with any questions you may have about a medical condition.
