India's Obesity Crisis Meets ‘Miracle Drugs' — Are We 'Flying Blind' Into Another Health Disaster?

Time of India

11 hours ago

New Delhi: As India grapples with a staggering 254 million people living with overweight or obesity, the arrival of weight-loss drugs or
weight-related drugs
has ignited both hope—and alarm.
At an exclusive Healthworld webinar, top Indian clinicians warned: this could be a transformative moment in
chronic disease care
, or it could spiral into unregulated chaos.
The experts had one message in unison: GLP-1s are not to be used as cosmetics. They are clinical tools. And misuse could unleash a crisis.
The webinar titled 'Weighing In: India's Medical Weight-loss Revolution,' the session brought together leading cardiologists, endocrinologists, and surgeons to examine to know if the new class of drugs are helping into major shift India's obesity or getting on to be a pandora's box.
The leading doctors participating in the panel were Dr. Ashok Seth, Chairman, Fortis Escorts Heart Institute, Dr. Shashank Joshi, Consultant, Department of Diabetology and Endocrinology, Lilavati Hospital & Research Centre and Dr. Muffazal Lakdawala, Director, General Surgery & Minimal Access Surgical Sciences, Edge & Reliance Foundation Hospital.
A few of the drugs in India that are used for weight-loss include Orlistat, Liraglutide (Victoza), Semaglutide (Wegovy and Rybelsus) and tirzepatide (Mounjaro).
Among these, Orlistat is one of the early drugs that was specifically approved for obesity treatment, while the others are among the newly approved for weight loss treatment.
Just as the hype grows, a Public Interest Litigation (PIL) has reached the Delhi High Court, warning against the aggressive marketing and uncontrolled sale of GLP-1 drugs in gyms and wellness clinics.
As the drugs grow in popularity, they are increasingly being peddled without prescriptions, fuelling fears of another health disaster.
'These are prescription-only drugs,' warned Dr Shashank Joshi, leading endocrinologist from Lilavati Hospital. 'They are meant for high-risk patients with obesity and metabolic diseases—not for healthy people chasing cosmetic goals. Dispensing them without supervision is not just illegal—it's dangerous.'
A New Era in Obesity Treatment—If Done Right
Unlike the banned appetite suppressants of the past, GLP-1 receptor agonists come with robust evidence from global trials. The SELECT trial showed a 20 per cent reduction in major cardiovascular events in patients treated with semaglutide.
'Obesity is no longer about appearance. It's a chronic, systemic disease,' said Dr. Ashok Seth, Chairman, Fortis Escorts Heart Institute. 'For the first time, we have a pharmacological tool that reduces not just weight, but real, hard endpoints like heart attacks and strokes. That changes everything.'
Dr. Muffazal Lakdawala, renowned bariatric surgeon, was blunt: 'India is sitting on a ticking obesity bomb. And if we let these drugs turn into gym-floor fads, we will be repeating the antibiotic misuse crisis.'
He added, 'These are not shortcuts to six-packs. They are meant for carefully selected patients. I reject 90 per cent of surgical weight-loss requests for being inappropriate—now imagine how many unqualified people are chasing these drugs for the wrong reasons.'
One of the most powerful takeaways from the panel was the push to reframe obesity not as a failure of will power but as a chronic, relapsing medical condition—with roots in genetics, environment, and biology.
'We must stop fat-shaming,' said Dr. Joshi. 'And we must stop using outdated tools like BMI alone. Indian bodies are metabolically different—what we call 'thin-fat'—lean on the outside but high in visceral fat and risk inside.'
Experts informed that lifestyle change remains essential, but for many, especially those with BMI over 27 with comorbidities, GLP-1 drugs may be the difference between disease progression and reversal.
The panel stressed that with power comes responsibility. India lacks a real-time pharmacovigilance system to monitor off-label use or adverse effects—unlike in the US or Europe.
'We are flying blind,' said Dr. Joshi. 'Without safeguards, this miracle will become a mess. Regulators must enforce prescription protocols and clamp down on black-market supply before it's too late.'
Talking about the affordability vs access of these weight-loss drugs the experts informed that with semaglutide injections priced at ₹26,000/month, affordability remains a major hurdle. But doctors argued that the cost of untreated obesity—dialysis, bypass surgeries, stroke rehab—is far higher.
Dr Lakdawala put it simply: 'We must think in terms of cost-effectiveness, not sticker price. And as generics enter the market, access can improve—but only if regulation keeps pace.'
This Is Science, Not Vanity
Across the board, experts made an urgent appeal to ditch the 'weight-loss drug' label.
'These are disease-modifying agents that can prevent diabetes, reverse fatty liver, and cut heart disease,' said Dr. Seth. 'Calling them cosmetic trivializes their life-saving potential.'
Dr. Joshi added, 'Let's not rob the sick to serve the slim. Off-label demand abroad has already caused shortages. India must prioritize medical need, not market hype.'
India stands at a crucial crossroads. With GLP-1 drugs offering a powerful tool to manage obesity, diabetes, and heart disease, the path forward must be one of caution, regulation, education, and equity, added experts.
Summing it up well, Dr Joshi said, "We are in the best of times for chronic disease innovation. But we're also in the worst of times—if we let hype override science.'