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India Today
18 hours ago
- Health
- India Today
Endocrinologist Dr. Ambrish Mithal on the happy side-effects of weight-loss drugs
New-age weight-loss drugs are exploding the pharmaceutical market, offering better results than traditional medicines. Top endocrinologist Dr. Ambrish Mithal deconstructs the many facets, including side-effects, of these GLP-1 drugs in his recently published book The Weight Loss Revolution, in an episode of India Today's said that while the GLP-1 field -- drugs that belong to the class of GLP-1 targeting the same hormone in the body -- is just beginning to explode, there'll be many newer drugs with less and less side effects and easier to most cases have shown muscle loss as a prominent result of using GLP-1 medications like tirzepatide or semaglutide, Dr. Mithal explains that losing muscle is an accompanying factor to weight loss. "In the long run, if you're not following a healthy diet, you will end up with significant muscle loss. And this is not because of the weight-loss drugs. Whenever we lose weight, we also lose muscle. If you lose 10 kg, you've lost 2-3 kg of muscle. Now, if you want to preserve that, you have to ensure adequate protein and fibre in your diet. Along with that, you have to make sure that you're exercising regularly and that exercise should include strength training," Dr. Mithal also shared what many people experience loose skin after taking these medicines. "When you lose weight rapidly, you lose subcutaneous fat. Particularly in older people where skin tends to sag anyway. If you suddenly lose weight, don't hydrate yourself well, not eating the right kind of balanced diet, then you get that little sagging on the face which people have started calling Ozempic face. Before these drugs came into the market, anyone we put on a very strict diet or someone who had bariatric surgery would see similar results," he gastrointestinal side-effects, nausea, and vomiting, Dr. Mithal addressed concerns about thyroid cancer, highlighting that there's no evidence to link the also explained the "happy side-effects" of GLP-1 medications. Besides growing body of evidence suggesting how semaglutide is linked to Alzheimer's disease, Dr. Mithal said that the benefits of the drugs are moving beyond weight loss."The evidence that they might be helping Alzheimer's by helping obesity in the brain may actually be very exciting, and even for cardiac health, Parkinson's disease. Cardiac events are reduced. Fatty liver is reduced. Kidney disease progression is reduced. But the brain effects are particularly fascinating. Sleep apnea has also gone down," he said, adding that the drugs have also helped improve fertility outcomes in women with PCOS (Polycystic Ovary Syndrome).Currently, most GLP-1 drugs are injectable and expensive, limiting their access in India. However, new formulations and more research are on the way. Novo Nordisk's Wegovy and Eli Lilly's Mounjaro, two blockbuster fat-busting medicines, are set to gain ground in India to tackle the diabetes and obesity crisis."Remember, the GLP-1 field is just beginning to explode. There'll be many newer drugs with less and less side effects and easier to use," Dr. Mithal sayssaid.- EndsMust Watch
India Today
2 days ago
- Health
- India Today
Side effects to surprises: Dr Ambrish Mithal on India's weight-loss drug revolution
India's struggle with rising obesity and diabetes is well documented. But a revolution is now underway, one that might reshape how we manage both conditions: the rise of GLP-1-based weight loss Ambrish Mithal, India's leading endocrinologist and author of his recently published book The Weight Loss Revolution, explains why these medications are here to stay, busting misinformation with METFORMIN: A NEW ERA IN DIABETES CARE For years, metformin has been the standard first-line treatment for type 2 diabetes. It's safe, inexpensive, and effective. But newer medications like GLP-1 receptor agonists and SGLT-2 inhibitors are rapidly changing that equation.'With these drugs, you're moving far ahead of metformin because there is clear evidence that these drugs produce significant weight loss they protect your heart, they protect your kidney, they very likely protect your liver too. These drugs are bound to replace metformin sooner rather than later," Dr. Mithal people with type 2 diabetes in India, nearly 80 to 90%, are overweight. That makes them ideal candidates for GLP-1 drugs, which aid in weight loss while managing blood sugar levels.'The bulk, the large chunk of 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,' says Dr. ALL FAT IS EQUALTraditionally, Body Mass Index (BMI) has been used to assess weight-related health risks. But Dr. Mithal points out that for Indians, BMI is misleading.'If you use just BMI, you will end up with a lot of Indians being classified as healthy when they have actually a lot of central fat or visceral fat," he said. Most people with type 2 diabetes in India, nearly 80 to 90%, are overweight. That makes them ideal candidates for GLP-1 drugs, which aid in weight loss while managing blood sugar levels. () This dangerous 'belly fat', also called visceral fat, triggers inflammation throughout the body. Dr. Mithal describes this typical South Asian pattern as TOFI -- Thin Outside, Fat ISN'T A MAGIC BULLETGLP-1 drugs now in India sold as Mounjaro and Wegovy, and semaglutide pills are not quick-fix solutions. Dr. Mithal stresses they must be part of a structured program that includes diet and exercise.'If you're using these drugs for weight reduction, don't depend on the drug alone,' he do this, he advises going on a high protein intake, adding more fibre in the diet, having small meals throughout the day and walking after MUSCLE LOSS RISKRapid weight loss, especially without strength training, can lead to muscle loss. 'If you lose 10kg, you've lost 2-3kg of muscle,' warns Dr. Mithal.'If you're using the drug just as a weight loss drug and doing nothing else you will also lose muscle.' GLP-1 drugs now in India sold as Mounjaro and Wegovy, and semaglutide pills are not quick-fix solutions. () He advises strength training and adequate protein to retain muscle mass and long-term health FACE AND OTHER SIDE EFFECTSThe popular term 'Ozempic face' refers to loose, sagging facial skin from sudden weight loss, not unique to these drugs.'Before these drugs came into the market, anyone we put on a very strict diet or someone who had bariatric surgery would have similar things.'Most side effects are gastrointestinal such as nausea, vomiting, and rare concerns include medullary thyroid cancer, although the link remains SIDE EFFECTS OF NEW-AGE DRUGSGLP-1 drugs have also known evidence of benefitting patients more than just weight and diabetes.'The data on these drugs is Alzheimer's diseas, better cardiac health, Parkinson's disease,' says Dr. Mithal. 'Sleep apnea goes down, fatty liver is reduced, and even kidney disease progression is reduced.' GLP-1 drugs have also known evidence of benefitting patients more than just weight and diabetes. () They may also improve fertility in women with PCOS. However, the drugs may reduce the effectiveness of birth control pills, leading to unintended pregnancies, famously known as Ozempic FOR EVERYONE AND NOT FOREVERThese drugs should not be used as public health tools, says Dr. Mithal. Prevention through lifestyle is still the best way to fight obesity. 'You can't eradicate obesity by using these drugs You have to eradicate obesity by preventing it," Dr. Mithal the long-term use of these medications depends on age, health goals, and reason for you're a 30-year-old, you certainly should not use a drug lifelong. I would take a deep breath after two years and see, what do I do now?' he most GLP-1 drugs are injectable and expensive, limiting their access in India. However, new formulations and more research are on the way."Remember, the GLP-1 field is just beginning to explode. There'll be many newer drugs with less and less side effects and easier to use," Dr. Mithal says.- Ends
Hindustan Times
3 days ago
- Health
- Hindustan Times
Weight loss drugs changing way we look at obesity: Dr Ambrish Mithal
Mounjaro and Wegovy have hit the market, and with this the global weight loss revolution has come to India. Dr Ambrish Mithal's book— The Weight Loss Revolution— that's released on Wednesday provides a detailed insight into these weight management drugs and how to use them, in the Indian context. Speaking to HT about the book, Dr Mithal— a renowned endocrinologist— highlights the need for generating awareness among masses about the role of these drugs, who are the right candidates for it, and the side-effects— even though mild— that one is likely to experience. Dr Ambrish Mithal Does it look like we have reached the stage where no less than a revolution is needed for weight-loss? Excess weight is a precursor to most modern metabolic disorders but unfortunately the tools to help us lose weight have been very limited. It's been more or less a disaster actually except for extreme cases when you went for surgery, which was utilised by a very small proportion of the population. You really didn't have much by way of drugs that help you lose weight. So, the reason I called it the weight loss revolution was that to address the modern metabolic sort of issues, we need to address weight. And for the first time, this whole crop of drugs that is coming out now, they are changing the way we look at it because they provide us the ability to actually help reduce excess fat and, therefore, reduce all the consequences of excess fat. I think it's a revolution because before this, you were struggling with much lower degrees of weight-loss. Do you think people still are largely ignorant about the harm that being obese does in terms of health? Yes, a majority of people look at weight as a cosmetic problem. And even now I am surprised every other day when I explain the relationship between something as obvious as wait and diabetes, many patients are unaware of the association. Even if they do understand the relationship between health and weight, sometimes that is not enough motivation for them to dive deep into obesity. People get motivated much easier by cosmetic issues than health issues. How is the current class of weight-loss drugs different from its predecessors? This is the class of drugs called GLP1 drugs, and this class we have been using now for almost two decades. These were developed for treating diabetes, and the initial ones worked very well for diabetes with additional benefits of weight-loss. Research in this area continued— the molecule kept on getting modified— and what made the semaglutide standout was the degree of fat-loss achieved, which was remarkable. It hit 15-16% of the baseline weight that had never been seen before. This is the same class of drugs— GLP1— but the incremental improvements were such that the degree of weight-loss one could achieve was substantially greater. Semaglutide and another molecule called tirzepatide (mounjaro)— a dual GIP and GLP-1 receptor agonist— have crossed the line for us in terms of efficacy and broken the barrier of treating obesity. What about the side-effects of these drugs? Anything that has effects will have side-effects. Fortunately, these drugs don't seem to have any sinister long-term side-effects, but yes, tolerability can be an issue with symptoms such as nausea, vomiting, constipation, or diarrhoea that in selected patients— a small proportion— can be troublesome. But these are transient effects. Some other long-term effects related to the eye etc. are still in the realm of research. Can the weight come back later, if one stops taking these drugs? In severely obese patients and patients with disorders linked with obesity, it certainly is going to be a life-long therapy. There, however, is a huge chunk of people who are in-between and we don't know yet whether all of them should be on life-long therapy or not. There's likely to be a period of aggressive weight-loss and then a period of weight maintenance that would probably require much lower doses. These drugs need to be a part of weight management programme and not a standalone treatment for obesity. The weight can come back after stopping these drugs, if you haven't tailored your lifestyle significantly.
