Weight-loss medication like Semaglutide and Tirzepatide has seen a rise in demand, causing a boom in sales. This exploding demand has caused many to wonder if they are indeed the magical solution to something as complicated as weight-loss.
In an interview with HT Lifestyle, Dr Shobha Subramanian-Itolikar, Consultant Physician at Fortis Hospital in Mulund, shared, “The impact of weight-loss drugs permeating the Indian drug market hit me hard when a colleague, who’s a plastic surgeon, commented about a surge in patients visiting their clinic for a post-weight loss mop-up procedure, either for snipping saggy abdominal skin or for tightening a fat-free chin after they discovered Semaglutide. In another instance, a patient who came to India for treatment from the Middle East, requested a prescription for a Tirzepatide injection, even before the drug had arrived on Indian shores.”
She explained, “Weight-loss drugs work by impacting metabolism, appetite, and the way the body stores fat. They cannot be purchased as over-the-counter medication and can only be prescribed by a medical practitioner. Most weight loss drugs were meant to be administered as treatment for those with Type 2 Diabetes Mellitus (T2DM), and weight loss was its unintended side-effect. However, their real purpose has been gradually eclipsed by the more interesting one i.e. aiding people to shed weight.”
The craze for these drugs is at an all time high and even people who don’t really need them (non-diabetic, non-obese people) are taking it to lose weight. Dr Shobha Subramanian-Itolikar revealed, “This has caused a shortage of these drugs in the market, and diabetics who actually need these drugs to achieve their glycemic goals are being deprived of it. The word ‘thin’ has now become synonymous with the word ‘healthy’. The thinner you are, the healthier you will be perceived. However, weight-loss drugs are not a recent discovery, they have always available in the market for almost a century; it started with Amphetamine in the 1930s.”
Many other drugs were developed to aid weight loss like Orlistat, Sibutramine, etc but these drugs were not without their ill-effects, failure to lose weight being one of them. Dr Shobha Subramanian-Itolikar highlighted, “Only recently have drug makers started focusing on the underlying etiology of ‘diabesity’ (deadly duo of diabetes and obesity) and thus come forth with the new-age weight-loss drugs. Weight-loss pills target the appetite of the individual and are successful in aiding weight loss. These drugs are the GLP1 receptor agonists like Exenatide, Liraglutde, Dulaglutide, Semaglutide and the dual GLP/ GIP Analogue Tirzepatide. Both these drugs are recent innovations that have taken the world by storm due to the promises they come with.”
Thus, it becomes imperative to take note of the advantages and disadvantages of drugs like Semaglutide, which are listed below.
Advantages:
- Aids in weight loss.
- Better control of 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.
Disadvantages:
- Minor tolerable side effects like nausea, vomiting, constipation and bloating.
- Weight loss is difficult to maintain once the drug is stopped and the lost weight is likely to return if aggressive dietary and lifestyle measures are not adhered to.
- In 20-50% cases the medicines do not cause weight loss.
- Exorbitant costs affecting adherence and continuation of therapy.
- Relatively new drugs and hence not much is known about them.
- Proposed risk of thyroid cancer as proven from rodent studies, similar data not available on human subjects.
- Recent reports of optic neuropathy leading to possible blindness – yet to be corroborated by researchers (very early reports).
- Risk of pancreatitis – rare but possible side effect.
- Contraceptive failure – data is sparse but possibility exists due to erratic absorption of drug due to delayed gastric emptying.
Dr Shobha Subramanian-Itolikar concluded, “Weight-loss process should ideally be purely organic i.e. eat clean, exercise regularly, sleep well and reduce stress. These drugs were developed keeping ‘diabesity’ in mind, although they have found off-label use in non-diabetic obese individuals. Such drug-aided weight loss should be advised only to people whose are morbidly obese, because these are the people who are unable to mobilise themselves in order to burn calories. For them, this is a better alternative to Bariatric surgery. Proper indications for its use should be defined by healthcare workers and regulatory authorities should monitor the usage of these drugs.”
Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.