Popular weight loss drug, semaglutide, is now available at a third of the cost following launch of generic versions made by Indian manufacturers. But while the lower price may draw more people toward the drug, physicians specialising in weight management and lifestyle medicine say it should not distract healthcare professionals from the bigger question of what these medications actually change in long-term obesity care.
For Karnataka, the development is especially relevant. With nearly one in four adults estimated to be living with overweight or obesity, demand for medical weight-loss solutions is expected to rise, particularly in urban areas where high stress, irregular meals, and increasing dependence on ultra-processed foods have created a fertile environment for metabolic disease. Experts caution, however, that while a lower price may bring semaglutide within budget for more people, it does not change the drug’s limitations.
Dr. Vanita Rahman, a US-based internal medicine physician, certified nutritionist and medical educator with the Physicians Committee for Responsible Medicine, said the weight loss seen with GLP-1 drugs is largely driven by reduced food intake rather than a correction of the underlying drivers of obesity. “GLP-1 drugs, like semaglutide, help some people lose weight because they suppress appetite and slow the rate at which the food leaves the stomach. As a result, people eat less and therefore they lose weight. However, the medications are only effective for a small number of individuals. Research from the SELECT study shows that only 12% of semaglutide users reached a normal body weight while 31% and 43% continued to experience overweight and obesity, respectively, after 4 years of use.”
Physicians also note that the medicines do not address the underlying causes of weight gain, such as low fibre intake, emotional eating, consumption of larger portion sizes, and high-caloric foods. This is why weight regain occurs when the medication is stopped.
“There is excitement around starting GLP-1 drugs, but far less attention is paid to what happens when people stop taking them. Research shows that 50% of GLP-1 users discontinue the medications within 12 months due to side effects, lack of efficacy, or cost issues. Studies also show that people regain the lost weight within 18 months of stopping the drugs. Research has also found that any cardiovascular benefits seen during GLP-1 use are also quickly lost when a person stops taking the medication,” says Dr. Rahman.
She emphasised the urgent need to refocus on nutrition-led approaches that address the root causes of obesity. “Multiple research studies have shown that consuming a whole-food plant-based diet can lead to weight loss similar to that seen with semaglutide and improve insulin sensitivity, reduce inflammation, and support gut health without the side effects associated with long-term drug use. Educating people about the role of nourishing foods and healthy eating habits in weight management addresses the underlying factors that are causing weight gain and leads to sustainable weight loss without lifelong dependence on medications for appetite suppression.”
Dr. Rahman conducted a series of sessions on GLP-1s and weight management across leading medical institutions, including Shri Atal Bihari Vajpayee Medical College, Ramaiah Medical College, and Bangalore Medical College, engaging over 300 healthcare providers. The sessions focused on equipping clinicians with practical, evidence- and nutrition-based approaches to sustainable weight management.
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