The Race To Cut Your Weight Is On; But What Should You Choose?

The race to strip your weight has already begun with pharmaceutical companies, digital healthcare firms and medical device organisations racing to prepare a shelf full of solutions that includes medicines, devices and digital therapeutics. The opportunity to bring these solutions for obesity is also immense as half of the world is said to be overweight and obese by 2030. 

According to a study carried out by the International Obesity Federation in 2023, 4 billion people globally or almost half of the world’s population are set to become overweight and obese by 2030 compared with 2.6 billion people in 2022. The report also says that the majority of the menace by obesity will affect low and middle-income countries. 

Presently there are a plethora of options available to shed that extra belly fat from digital therapeutics, GLP1 medicines, and inflatable balloons to bariatric surgery.

But what should be your first choice? Well, clinicians say that the decision largely relies on the patient’s preferences and what they feel comfortable implementing. While also considering the patient's ability to adhere to the chosen option successfully. 

“The prescription of different weight loss options to different individuals should be based on a personalised approach. Healthcare professionals should consider factors such as the individual's current health status, body composition, medical conditions, and lifestyle habits,” said  Dr Venugopal Pareek, Consultant GI Laparoscopic and Bariatric Surgeon, CARE Hospitals Banjara Hills, Hyderabad. 

Using Digital Therapeutics 

Digital Therapeutics is fairly a new kid on the block in India which has started to make some noise as a possible solution for weight loss among other behavioural habits that it tries to solve. The global market for digital therapeutics in 2022 stood at USD 4.5 billion and is poised to touch USD 17.7 billion as per a report by market research firm Markets and Markets. 

“Using digital therapeutics for weight loss can be effective and beneficial. These innovative solutions leverage technology, such as mobile apps and wearables, to provide personalised guidance, track progress, and offer behavioural support,” stated Dr Anand K, Chief Consultant, Plastic and Reconstructive Surgery SPARSH Hospitals, Bangalore.

A 2022 research published in the US journal PubMed showed that digital therapeutics when compared with physical in-person workout regimes were cost-effective. The research also noted that the online therapeutics were non-inferior to lifestyle interventions implying they do indeed work in the weight loss journey.

"However, their success may depend on the individual's motivation, adherence to the program, and the quality of the digital platform being used," Dr Pareek delineated.

The GLP1 Drugs Phenomenon

Medications are also becoming quite popular these days to reduce weight with GLP1 drugs taking centre stage. GLP1 drugs have become highly recommended due to their diverse treatment profile effective in lowering sugar levels, reducing obesity and providing cardiovascular risk benefits. 

Global pharmaceutical companies such as Novo Nordisk and Eli Lilly are in the process of developing GLP1 drugs for obesity at breakneck speed with clinical results claiming a weight reduction of at least 15 per cent over 60 weeks. Indian drugmakers such as Sun Pharmaceuticals and Biocon are also exploring options and have shown interest to foray into the peptide drugs. 

For obesity, the clarity on how the peptide drugs actually work is still less but clinical experts believe that the drug helps in curbing hunger and also slows the movement of food from stomach to small intestine making a person eat less.

“As GLP-1 receptor agonists effectively reduce appetite, it is especially beneficial for patients who struggle with controlling their eating habits, such as those who tend to consume large quantities of food,” said Dr Harish Kumar, Senior Consultant, Obesity Clinic, Amrita Hospital, Kochi. 

Dr Kumar further said they can lead to weight reductions of about 5 to 10 per cent but are fairly expensive and need to be continued over an extended period for sustained weight loss. "The drugs can also cause gastrointestinal issues such as nausea and very rarely, vomiting during the early stages of treatment. However, it's important to note that these side effects usually diminish after the first month, and the majority of patients tolerate the medication well,” Dr Kumar added. 

Speaking on the safety of GLP1 Drugs in the long run Dr Pareek said that their long-term safety is a subject of ongoing research and monitoring and long-term studies are necessary to determine the safety and efficacy of GLP1 drugs for sustained weight loss. 

Balloons Bursting Fat

Another lucrative option these days towards the weight reduction journey is just to swallow a balloon pill that gets inflated post reaching in the stomach and presents itself in the shape and size of a small balloon. 

The companies making the pill balloons claim a non-permanent weight reduction up to 10 per cent. Clinicians say that inflatable balloons temporarily occupy space in the stomach, leading to feelings of fullness and reduced food intake. 

However Dr G. Moinoddin, Consultant, Bariatric and Advanced Laparoscopic Surgery, Manipal Hospital, Millers Road stated, “There is a recent trend of swallowable balloon pills to lose weight, but they have a very validity of around 4 to 6 months. After this period, patients often revert to their previous eating habits. These balloons can be a helpful initial push for weight loss, but patients should follow permanent lifestyle modification for long-term results.”

Surgery For Severely Obese  

Clinicians offer bariatric surgery as an option to only those patients who have severe obesity and have been unable to achieve weight loss despite trying lifestyle modifications and medications. 

“Physically, they may face difficulties in mobilising, and they often develop various health issues such as diabetes, high cholesterol, and high blood pressure. Obese individuals may also suffer from obstructive sleep apnea, leading to disturbed sleep at night,” Dr Kumar pointed out. 

Dr Moinoddin enumerated that Bariatric surgery has been available for the last 50 years, and over time, the safety of the procedure has significantly improved with complications becoming only 5 per cent due to strict protocols.

Least Harmful and Sustainable Ways

Clinical experts give their mandate to lifestyle modifications such as a well-regulated diet, exercise, yoga, and meditation calling them the most sustainable and least harmful options in the long run. Experts said that while the results may take longer to achieve compared to some medical interventions or surgeries, they are more likely to be maintained in the long run.

“They promote long-term behaviour modification and overall health improvement. These changes also reduce the risk of developing obesity-related diseases such as diabetes, cardiovascular issues, and joint problems,” said Dr Pareek.

On the other hand, experts also say that it is essential to emphasise a scientifically conducted diet, avoiding extreme practices like fasting or skipping meals. "When diets are appropriately planned, they can have long-term benefits without causing harm to the body," Dr Kumar explained.