Doctors warn against self-medicating with weight-loss injectables

PUNE: With India cementing its position as the global capital for diabetes mellitus, the arrival of GLP-1 (glucagon-like peptide-1) receptor agonists — a class of injectable medications — has been hailed as a breakthrough for millions.

GLP-1 is a natural hormone in the body that helps regulate appetite and blood sugar and the effectiveness of these drugs, especially in controlling weight, has driven an unprecedented demand for these drugs.However, in view of World Obesity Day on March 4, medical experts have called for tighter regulations, warning that the promise of rapid weight loss often obscures the risks of unsupervised use.


The surge in demand has triggered a wave of generic alternatives. To curb potential abuse, the Central Drugs Standard Control Organisation (CDSCO) subject expert committee (SEC) issued a mandate in Jan this year, explicitly stating that these injectables must only be prescribed by registered endocrinologists.

Dr. Reema Kashiva, director, Centre of Excellence for Diabetes and Obesity at Noble Hospital and Research Centre, Pune, emphasised that the benefits of drugs like semaglutide far outweigh the risks but only when used judiciously.

"Most patients who suffer side effects severe enough to require hospitalisation are those who took the medication without medical supervision," Dr Kashiva said. "Semaglutide should be prescribed only by certified bariatric physicians and endocrinologists. While the WHO has declared it safe, rapid blood sugar lowering must be managed carefully. We need robust regulatory guidelines before more biosimilars enter the market."

Doctors are particularly concerned about individuals sourcing these medications through informal channels for cosmetic purposes.

Dr. Sandeep Kharb, senior consultant in endocrinology at Asian Hospital, warned that misuse is becoming a public health crisis. "We are seeing people self-adjusting doses or using these drugs purely for aesthetic weight loss without understanding the metabolic consequences," he said. "Such practices can lead to electrolyte imbalances, gallbladder issues, and pancreatitis. These are not quick fixes; they are part of a broader clinical plan that includes diet, activity, and regular monitoring."

Echoing this sentiment, Dr. Rakesh Pandit, head of the department of internal medicine at Aakash Healthcare, said that while these drugs represent a major breakthrough, they are potent prescription medications, not lifestyle supplements. "A comprehensive metabolic evaluation, including liver, kidney, and pancreatic health, is mandatory before starting therapy. Inappropriate use can lead to persistent nausea, dehydration, and in rare cases, visual disturbances," Dr Pandit added.

Despite the warnings, the medical community acknowledges that the popularity of GLP-1 drugs has helped shift the narrative around weight.

"The interest in these injections shows that people are finally realising obesity is not just a failure of willpower," said Dr Mukesh Budhwani, senior general physician and diabetologist at Apollo Clinic. "It is a chronic, relapsing medical condition influenced by genetics, hormones, and metabolism. For the right patient, semaglutide and tirzepatide can improve heart health, fatty liver, and blood pressure. However, the distinction between a medical necessity and a cosmetic trend must be maintained." Dr Budhwani added.

The consensus among India's leading physicians remains clear: while GLP-1 therapies are a powerful tool in the fight against the twin epidemics of diabetes and obesity, they must remain firmly under the scalpel of professional medical scrutiny.
Get the latest lifestyle updates on Times of India, along with Holi wishes, messages and quotes !