The Beat Report | A journalist's dilemma: Weighing the good and bad of weight-loss drugs

In The Beat Report, Mint's journalists bring you unique perspectives on their beats, breaking down new trends and developments, and sharing behind-the-scenes stories from their reporting.

Good morning!

“It’s never been easier to lose weight”: that’s the general consensus on the internet as, over the last five years, weight-loss drugs such as Ozempic and Mounjaro have taken the world by storm.

My entry into the world of pharmaceuticals as a reporter somewhat coincided with the entry of these so-called wonder drugs into India. As I reported on this over the past year, I heard executives and analysts marvel over this novelty. “We’ve never seen a category like this,” one said. “This is one of those rare drugs that patients know of even before going to the doctor,” said another.

One particular conversation sticks out. I was chatting with a senior executive of an international drug company just ahead of the launch of a blockbuster weight-loss drug in the country. “I know the market is big, but I’ve rarely seen another drug tracked this closely,” he said. “I’m very curious: What is it that’s got you and other journalists so interested?”

Yes, the market will be massive, and that’s indeed the first reason I told him. Some analysts reckon that the market for these drugs in India (already an estimated ₹1,000 crore!) will grow by 10 times even before the turn of the decade. No wonder investors want to know every single development: Who has the manufacturing capacity? What’s the tier-II and tier-III strategy? How long do people use it for? Where do they prefer to buy it from?

Then there’s the belief that the impact of these drugs—in a category now being called “cardiodiabesity”—will reach far beyond just the pharma industry, and will even seep into retail, wellness, fitness, consumer goods, hotels and more, I said.

But that’s not it.

The fa(c)t of the matter

The reason we track and read news about these drugs so eagerly is more intrinsic. Conversations around fatness in our society have been as ubiquitous and relentless as our beloved Mumbai rains.

In my free time, I read Substack essays on the politics of fatness, watch YouTube videos analyzing “the return of the ’90s thinness” and the “Ozempic face” and read endless think-pieces on the perils of equating thinness with good health.

“People treat you better when you are thin—even doctors,” a friend with PCOS (polycystic ovary syndrome) told me a few months ago as we discussed her struggles to lose weight. Her symptoms worsened with weight gain, and yet, until she lost weight, she found very little sympathy.

My own experiences with my body, as well as countless discussions with friends who have grown up like me, have made me wary of the frenzy surrounding these drugs. But I’d be lying if I said I was not tempted to try one myself. After all, if I was reporting on the market dynamics and growth of these drugs regularly—and amplifying their growth in a way—it was my responsibility to understand what they really did to a person.

But of course, no doctor would prescribe such a drug to me! I am by no metric overweight, nor am I diabetic. Yet, I was curious. So I did what a journalist is supposed to do: talk to people.

The weight of expectations

Somewhere around July, Wegovy had just been launched in India, and Mounjaro had gained enough ground for me to start finding patients ready to talk about their experiences. The people I got in touch with were mostly medically obese, diabetic or pre-diabetic, and more open to a medical intervention for obesity, given their experience with diabetes.

One user, in his mid-30s, told me it was the first time in 16 years his weight had dipped into double digits. It’s not like he hadn’t tried before: he had tried exercising, dieting, and supplements. It was only when his latest bloodwork revealed that he had inched into the pre-diabetic category that he was recommended Mounjaro.

While chatting on the phone, I told him about my doubts and how the excitement and frenzy made me uneasy. “It’s not like it’s a life-saving cancer drug,” I said. “For me, it was,” he replied. At 35, weighing 112 kg and being pre-diabetic, he was at high risk of various comorbidities, including a heart attack and stroke. He had lost about 15 kg when I spoke to him.

There’s a host of lifestyle changes to make for the medicine to work. Simply put, GLP-1s (the class of drugs we’re talking about) reduce your appetite by slowing your digestion and regulating your feelings of hunger and fullness. This makes it easier to eat less and stick to a calorie deficit. It also regulates your insulin and sugar levels. This means that eating sugary or highly processed foods while taking a GLP-1 could counter its effect.

Obesity is now recognized as a disease in various countries. The World Health Organization added GLP-1s to its list of essential medicines this year. The frenzy around these drugs has spurred growing research on the effects of obesity on health and the genetic predispositions for weight gain. The age-old advice of “eat less, move more” and blaming a person for their own weight gain seems to be fading. If obesity is a disease, it can be treated.

But there remains the very prevalent set of people using GLP-1s to look a certain way—we’ve already seen a host of celebrities and influencers drop the pounds swiftly. Doctors fear that people will increasingly use these drugs to lose the “last 5kg” before a wedding. There are the very real social implications of living in a society where being fat is either equated with being ill or seen as something to be fixed.

As I continue to be conflicted, I’ll go on doing what we journalists do best: track the good and the bad, and watch how things shape up. What’s your take? Would you like to speak with me about your experience? Go ahead and share your thoughts in the comments section, or drop me an email: jessica.jani@livemint.com.

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