Dr Ambrish Mithal decodes benefits of new weight-loss drugs
Dr Ambrish Mithal decodes benefits of new weight-loss drugs
Jun27,2025
Credit: India Today
Most type 2 diabetes patients are overweight, need to lose weight, and losing weight will help them even reverse or at least treat their diabetes better.
Reverses diabetes
Dr. Mithal describes body fat distribution in India is more on the belly. This, he says leads to a BMI lower than 30. However, the drugs can be used for someone whose BMI 27 and lower with comorbidities.
Skinny fat Indians
Dr. Mithal says that GLP-1 drugs are not magic but are powerful when taken along with proper diet high in protein and strength training.
Credit: Getty Images
GLP-1 drugs are not magic
Rapid weight loss, especially without strength training, can lead to muscle loss. Therefore, while taking the medicines, ensure you exercise and have a proper diet to avoid severe muscle loss.
Does it lead to muscle loss?
The medicines have shown to slow the progression of Alzheimer's disease, and even reverse fatty liver.
Happy side-effects
GLP-1 drugs can help improved infertility in women with PCOS.
Beyond weight loss
Weight-loss drugs are not for everyone. Dr. Mithal says that assessing various factors like obesity and diabetes are required before prescribing the medicines.
Not for everyone
'You can't eradicate obesity by using these drugs you have to eradicate obesity by preventing it," Dr. Mithal says.
Forever drugs?
For years, metformin has been the standard first-line treatment for type 2 diabetes. But newer medications are rapidly changing that equation, says Dr. Ambrish Mithal in conversation with Sneha Mordani for India Today's Booked.
Beyond Metformin
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While it was already seeing off-label use for this purpose, semaglutide finally received approval for obesity management from the US regulator in 2021. In addition to the 15% average weight loss, trials with semaglutide have demonstrated its ability to reduce the risk of major cardiovascular events (such as heart attacks and strokes) by 20%, and the risk of all-cause mortality by 19%. Studies have shown a 69% reduction in heart failure events. There is also evidence that the drug can resolve fatty buildup in the liver in 63% of patients and improve liver fibrosis — the hardening of liver tissue due to fatty deposits — in 37% of cases. Tirzepatide, which uses an additional target gastric inhibitory polypeptide (GIP), has been shown to lead to a weight-loss of up to 20% of the body weight. The medicine was also approved for the treatment of obesity-related obstructive sleep apnoea — a condition where a person's breathing stops and starts while they sleep. Trials have also shown that it can improve lipid profile, and demonstrated a 20% reduction in the risk of cardiovascular as well as all cause death. 'There is no doubt that the medicines are effective for kidney and heart conditions. There is also evidence that has emerged about fatty liver disease. But, what I am most excited about are the happy neurological side effects. There seems to be some evidence to show that the medicines are associated with lower risk of Alzheimer's and other dementia,' Dr Ambrish Mithal, chairman of endocrinology and diabetes at Max Healthcare, told The Indian Express. He added: 'Importantly, these drugs have reduced cravings in people. They are not only eating smaller meals but also healthier ones. Sweet cravings have gone down. There is also evidence to show that it helps with alcohol addiction.' Bolstered by the success of semaglutide and tirzepatide, several other drugs are now in the pipeline. 'There are a lot of drugs that are in the pipeline, including drugs with once-a-month dosing instead of every week and very effective oral pills,' Dr Mithal said. Trials are ongoing for drugs such as retatrutide that uses three targets: GLP-1RA and GIP used by its predecessor tirzepatide along with glucagon. There is also CagriSema that uses two targets GLP-1 RA and a new Amylin receptor agonist. Oral GLP-1 drugs such as orforglipron and danulipron may soon be available as well. Two other drugs, which use two targets GLP-1 RA and glucagon — Survodutide and Mazdutide are also in phase 3 clinical trials. Anonna Dutt is a Principal Correspondent who writes primarily on health at the Indian Express. She reports on myriad topics ranging from the growing burden of non-communicable diseases such as diabetes and hypertension to the problems with pervasive infectious conditions. She reported on the government's management of the Covid-19 pandemic and closely followed the vaccination programme. Her stories have resulted in the city government investing in high-end tests for the poor and acknowledging errors in their official reports. Dutt also takes a keen interest in the country's space programme and has written on key missions like Chandrayaan 2 and 3, Aditya L1, and Gaganyaan. She was among the first batch of eleven media fellows with RBM Partnership to End Malaria. She was also selected to participate in the short-term programme on early childhood reporting at Columbia University's Dart Centre. Dutt has a Bachelor's Degree from the Symbiosis Institute of Media and Communication, Pune and a PG Diploma from the Asian College of Journalism, Chennai. She started her reporting career with the Hindustan Times. When not at work, she tries to appease the Duolingo owl with her French skills and sometimes takes to the dance floor. ... Read More
