NEW DELHI: Drugs which are approved to treat diabetes and diabesity (coexistence of both diabetes and obesity) are being used off-label for “weight loss” by people. Doctors have warned against using these drugs without consultation as they may cause increased risk of gastritis, pancreatitis, gastrointestinal effect along with hypoglycemia.
These drugs (Semaglutide, Liraglutide, Dulaglutide) fall in the category of glucagon-like-peptide-1 (GLP-1)receptor agonist drugs. According to doctors, some of these drugs have been approved for weight management in non diabetic cases in the US but not in India. Their congeners are being used in India by people for weight loss.
Dr Sanjay Verma, director GI, Minimal Access and Bariatric surgery Fortis hospital Escort, Okhla, said, “I come across 4-5 non diabetic patients every month who use these drugs for weight loss. Usually they complain of nausea, vomiting and hypoglycaemia (can occur with malnutrition and starvation when you don’t get enough food) and some of them may also have pancreatitis.”
“These anti-diabetic drugs are being used for weight loss with increased doses,” he claimed, adding that however, when these drugs are stopped, the weight returns as these are not a permanent solution. Each month’s medication which is available in injections cost Rs 20-25,000,” he said.
Explaining the use of various medications for weight loss, Dr Vivek Bindal, director and head, Max institute of Minimal access, bariatric and robotic surgery, said that Liraglutide has been available for long, which is once a day injection, dulaglutide was once a week injection and now semaglutide which comes both in once a week injection and oral tablet form as well. These have been approved in India for use in diabetes patients. “Among these, semaglutide injection which is not approved by Indian authorities for weight loss but is approved by US FDA for the same, are being imported from abroad by those who are willing to shell out extra bucks,” he said.
Talking about consequences of using these drugs for weight loss, Dr Bindal said, patients have to maintain nutrition level with these medications because they tend to eat less after having these medicines. “If they are not taking enough supplements or diet under medical supervision, they can go into malnutrition also,” he said, adding that pancreatitis is another side effect which can happen with this. Also, people who have a family history of Multiple endocrine neoplasia (MEN) syndrome, should not be taking these medications.
As per studies, around 5-10% total weight loss with semaglutide is within six months to one year.
“Without medical supervision, these drugs should not be used as they could have harmful side effects,” warns Dr Sudhir Kumar Kalhan, senior consultant, minimal access and bariatric surgery centre. One should understand that obesity is a lifestyle disorder and there are no shortcuts to that.
Since these are recent drugs, there are no long term studies to indicate their side effects.
