Obesity is not just a lifestyle issue but a chronic disease that requires sustained medical intervention, said Vikrant Shrotriya, Managing Director of Novo Nordisk India, at the India Today Conclave 2025 on Friday.
As the global demand for obesity treatments skyrockets, Shrotriya provided insights into the complex nature of obesity, the science behind weight management, and the role of medications like Ozempic amidst growing conversation around obesity and the long-term use of weight-loss drugs. He emphasised that nearly 40% of the global population is either obese, overweight, or has central obesity, and in India, even individuals with a normal BMI often carry excess visceral fat due to genetic predisposition—making them vulnerable to lifestyle diseases. This phenomenon, often referred to as Thin Fat India, is an emerging health concern.
Shrotriya pointed out that the World Health Organization (WHO) classified obesity as a disease in 1994, and countries such as the US, UK, and Canada now recognise it as a public health crisis due to its links to diabetes, cardiovascular disease, fatty liver, osteoarthritis, and infertility. He noted that while weight loss has traditionally been prescribed through diet and exercise, research indicates that 95% of those who shed weight this way regain it within a few years.
"The human body is wired to resist weight loss—metabolism slows, and hunger hormones increase as weight drops, making it difficult to sustain," he explained. He likened overeating to smoking, saying it is not merely a voluntary habit but is influenced by metabolic and physiological factors.
It is in this context that GLP-1 receptor agonists like Ozempic have emerged as game-changers. Initially developed for diabetes, these drugs mimic a hormone that regulates appetite and insulin levels, leading to significant weight loss. Clinical trials show that people using semaglutide, the active ingredient in Ozempic, lose an average of 15-20% of their body weight. This success led to the development of Wegovy, a higher-dose version specifically designed for obesity treatment.
However, a major challenge remains—weight regain after discontinuing the drug. "Just like medications for hypertension or diabetes, weight-loss drugs may need to be taken long-term to maintain results," Shrotriya said. He explained that most metabolic disorders, including obesity, tend to relapse when treatment stops. "When a diabetes patient stops medication, blood sugar levels rise again; similarly, when weight-loss treatments are discontinued, the body often returns to its previous weight," he noted. While some individuals may transition off the drug with the support of diet and exercise, many will likely require continued medication to sustain their results.
Despite the global demand for Ozempic, the drug is not available in India. Novo Nordisk is yet to launch the drug in the Indian market post regulatory and commercial considerations. However, the company has other weight-loss medications available in different countries. Saxenda (liraglutide), approved for obesity treatment, is sold in the US, UK, Canada, and parts of Europe. Wegovy (semaglutide), a stronger version of Ozempic specifically designed for weight loss, is available in the US, UK, Germany, Denmark, and Japan. Ozempic itself, though primarily a diabetes drug, is often used off-label for weight loss in countries such as the US, Canada, and several European nations. In India, Novo Nordisk launched Saxenda in 2023, but its adoption has been limited due to high costs and restricted availability.
Shrotriya also cautioned that while these drugs offer promising results, they come with potential side effects. Common issues include nausea, vomiting, diarrhoea, constipation, and fatigue, while more severe risks include pancreatitis, gallbladder issues, and kidney complications. He highlighted concerns about muscle mass loss alongside fat reduction, stressing the importance of maintaining a balanced diet with adequate protein intake. Additionally, some studies suggest possible mental health effects, including increased risks of depression and suicidal thoughts, though he noted that more research is needed in this area.
Affordability remains another major hurdle, especially in developing countries. With surging global demand, Novo Nordisk has invested nearly $25 billion in expanding production capacity, though Shrotriya admitted that costs remain high. "As manufacturing scales up, we expect prices to come down," he said.
The rising popularity of Ozempic has also raised concerns about misuse, with many individuals using it for cosmetic weight loss despite not meeting medical criteria. Shrotriya warned that unsupervised use can lead to complications. While the drug is effective, he stressed that it is not a magic bullet. "Treating obesity early can prevent severe complications and reduce healthcare costs in the long run," he said.