Doctor explains: Should you take medicines to lose weight?

About 43 per cent of adults (18 years and above) or 2.5 billion people in the world are overweight, according to a World Health Organisation (WHO) report, citing 2022 figures. Of these, 890 million are living with obesity. The WHO says that adult obesity has more than doubled since 1990, and adolescent obesity has quadrupled. And about 37 million children worldwide are overweight. A study by the Lancet recently said that India too is sitting on an obesity epidemic curve.

What being overweight or obese does to our body and life? We spoke to Dr Atul Luthra, director of the endocrinology department at Fortis Memorial Research institute, Gurugram to understand it. Excerpts:

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Is being slightly overweight a cause for concern, or is it only when one is significantly overweight?

Even if somebody is slightly overweight, it can pose serious health risks as it can contribute to various metabolic disorders. However, the degree of concern varies depending on individual factors such as age, overall health, and genetic predisposition. If someone is slightly overweight but does not have any physical disability or metabolic concern, then it’s inconsequential obesity.

How does excess weight impact common conditions like diabetes, heart disease, and hypertension?

Excess weight significantly increases the risk of developing diabetes, heart disease, and hypertension. Because of chronic inflammation, insulin signal is disrupted, leading to insulin resistance. Chronic inflammation in the arterial system causes blockage in arteries.

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What’s the most common misconception about being overweight?

One common misconception is that overweight individuals have faulty lifestyles and lead an undisciplined life. The fact is that obesity is contributed by genetic, hormonal and environmental factors.

There are clinics that advertise various ways and medications to lose weight. What are the most commonly prescribed weight loss medications, and how do they work?

Commonly prescribed weight loss medications include Orlistat, which reduces absorption from intestines. There are also Liraglutide and Semaglutide, which reduce appetite by delaying stomach emptying and by stimulating satiety through the brain.

A study, published earlier this week, found that drugs like Wegovy and Ozempic, can cause abdominal paralysis. Can you explain the potential risks and side effects associated with weight loss drugs?

Potential risks associated with weight loss drugs include delay in gastric emptying and reduced motility of the entire digestive system.

How do you determine if someone is a good candidate for weight loss medication?

If someone is obese with one or more cardiovascular risk factors or obesity-related core morbidities, then they are a good candidate for weight loss medication. CVRFs(cardiocvascular risk factors) such as hypertension and dyslipidemia or conditions such as fatty liver and sleep apnoea.

What safe alternatives do people looking to lose weight have?

Lifestyle modifications, including a balanced diet, regular exercise, and behavioural therapy, are the safest options for weight loss. These approaches not only promote sustainable weight loss but also improve overall health.

What role does mental health play in weight management?

Being obese leads to loss of self esteem. Moreover, obese people are often stigmatised in society which can lead to depression. Therefore, mental health plays a significant role in weight management, as psychological factors such as stress, depression, and emotional eating can impact eating behaviours and adherence to weight loss strategies.

How big a factor is weight in the management of diabetes?

Patients of diabetes who are overweight have high levels of insulin resistance and require high doses of drugs for diabetes control. Moreover use of certain drugs including insulin can lead to weight gain. A controlled diet plan and regular physical activities are essential to control body weight. Achieving and maintaining a healthy weight can significantly improve diabetes outcomes and reduce the risk of complications.