NEW DELHI: India’s top endocrinologist, Dr Ambrish Mithal has come out with a very well timed and a much needed explainer on the new crop of weight loss drugs that have flooded the market. Entitled, “The Weight Loss Revolution: Weight Loss Drugs and How to Use Them” the book is coauthored with writer and senior journalist Shivam Vij. In fact, apart from the to the point headline, the book comes with a heartfelt dedication—“To all the brave souls who’ve survived countless diet plans”.
That should strike a chord the world over. This is a book whose time is now. For if there is one constant topic in the drawing rooms of today it is around Ozempic, Mounjaro, Wegovy and Rybelsus. The battle of the bulge is one that is fought globally and suddenly the losing side has been handed a potent new weapon. But the questions remain. How effective are these drugs? Who should take them? What are the sideeffects, both short and long term? Are these to be taken life-long? What if one wants to lose only a few kgs for a wedding? And most important of all— how do these work? All these queries, and some more, are tackled in the book. It is an easy to read 187 pages, written in a simple accessible manner. The fact that the author is an expert in his field, has only added to the book’s credibility. I have a feeling that one of the reasons that Dr Mithal wrote this book is the amount of people who must be accosting him as social-dos and professional consultations, wanting to all that is to know about these new “wonder” drugs.
Another welcome addition in the book is that we don’t just hear the voice of the doctor because there are also numerous case studies told to us in the first person (with the names being changed). These case studies belong to different age groups, genders and medical histories, so we do get a pretty comprehensive coverage about the drugs and their impact. How do these medicines work? These are essentially GLP-1 and GIP drugs. As the book explains, “After we eat food, the GLP-1 tells the pancreas to produce insulin. Insulin lowers blood sugar. Simultaneously GLP-1 reduces the release of glucagon, the hormone that increases blood sugar. GLP-1 also delays how quickly the food leaves the stomach, making you feel full. It also tells the brain to reduce appetite.
Thus GLP-1 is a key spoke in the wheel of metabolism… All of us produce GLP-1 as a response to eating food but it disappears in no time. It has a `half-life’ of just two minutes, meaning half of the GLP-1 produced in our bodies in response to food is degraded within two minutes.” Hence what these drugs do is to produce molecules that mimic the natural hormones, travelling to the GLP-1 receptors in our bodies and activating them. Dr Mithal further explains (and I paraphrase here): These help in weight reduction through four main actions—by giving you a feeling of fullness for a longer time; by making the pancreas produce more natural insulin, but only in response to high blood sugar; by reducing the sugar raising hormone glucagon and by telling the train to make the person eat less.
As Dr Mithal adds, “Until recently the only option for the severely obese patient was bariatric surgery…. (as) none of the anti-obesity medicines developed before semaglutide and tirzepatide (Ozempic and Mounjaro) have stood the test of time.” However, all this has changed since. These drugs are currently not being sold over the counter and Dr Mithal cautions time and again the importance of taking these under medical supervision. Obesity is not just a lifestyle concern, it is a very serious medical condition. Prime Minister Narendra Modi has also highlighted this issue and a study in “The Lancet” estimates that as many as a third of India’s population will be over-weight or obese by 2050.
The answer to this challenge could lie in these new GLP-1 and GIP drugs. We have indeed what Dr Mithal calls another Statin moment in our medical history—it has its naysayers and blind believers; but if used with caution herein lies an answer to womankind (and mankind’s) oldest and one of our most pressing health concerns. For all those concerned about their weight and are contemplating the “To Ozempic or to Mounjaro” question; or even if you just want to know what the rest are talking about, this book is a must read.
