Promises and pitfalls

There is growing excitement about anti-obesity drugs and their potential to combat the country’s rising obesity epidemic. Indeed, we are stepping into a new era of highly effective obesity treatments. But the question is: Will these drugs work in isolation without addressing the broader issues of unhealthy diets and sedentary lifestyles, which are all pervading in India?

Here are some key benefits of these drugs, along with considerations for their responsible use. Despite widespread awareness of healthy diets and importance of exercise, many fail to achieve significant weight loss due to genetic, hormonal, or behavioural challenges. For those who have tried and failed conventional approaches, these drugs, such as semaglutide and tirzepatide, provide a science-backed option to help manage their condition. These medications work by mimicking natural hormones that regulate appetite and blood sugar, essentially “tricking” the brain into feeling fuller for longer periods.

This is beneficial for those with obesity-related complications such as diabetes, hypertension and heart diseases. When used properly under medical supervision, these medications promote gradual and sustained weight loss over time, reducing risk of regaining lost weight. Additionally, these drugs offer benefits such as better blood sugar control, lower cholesterol levels, and reduced cardiovascular risk. Studies suggest it can also slow kidney disease progression and significantly decrease obstructive sleep apnea, making it a good intervention for multiple health issues.

These drugs are available in oral and injectable forms. Anyone thinking of using them should do so under medical supervision. Side effects such as nausea, vomiting, and, in rare cases, pancreatitis can occur. Progress of patients on these drugs must be monitored closely. Moreover, stopping the drug may lead to weight regain, so it should be seen as a long-term commitment rather than a quick fix.

However, anti-obesity drugs will not play any significant role in solving India’s obesity crisis. These will never address the root problem affecting millions across the country—widespread consumption of energy-dense foods and increasingly sedentary lifestyles. The socioeconomic reality of India makes these drugs even less viable as a population-level solution. With costs ranging from Rs 10,000 to Rs 40,000 a month for branded versions, these drugs remain far beyond the reach of average Indian citizen. Even the more affordable generic alternatives represent a significant financial burden for middle-class families, let alone those from lower-income backgrounds.

What India needs urgently is comprehensive policy reforms that address aggressive marketing of unhealthy foods, particularly directed at children, improved nutritional literacy, public health campaigns and urban infrastructure that promotes active living. Used wisely, these medications can help transform individual lives but they should be viewed as part of a comprehensive, long-term approach to weight management rather than a magic bullet. The solution to India’s obesity epidemic lies in systemic change, not in a prescription.

(Anoop Misra is executive chairperson, Fortis C-DOC Hospital for Diabetes and Allied Sciences, New Delhi)

This column was originally published as part of the article The Big Pharma Fix in the April 16-30, 2025 print edition of Down To Earth