As the market for anti-obesity drugs in India grows rapidly, pharma majors like Dr. Reddy's, Zydus, and Sun Pharma are competing to quickly enter the market with weight-loss drugs
Indian pharmaceutical companies are hungry for the next frontier: drugs to fight obesity, a condition that has become the biggest worry for the urban well-off as they gorge on calorie-dense food (read: junk and fast food) and lead unhealthy lifestyles.
Anti-obesity drugs are big business in the West, where obesity has reached epic proportions (according to the Global Obesity Observatory, 36.47 per cent of the US adult population is obese). As well-travelled Indians bring back the pills, Indian companies have scoped the business and want a share of the action.
Indian pharma companies already have a spectrum of drugs to tackle diabetes and a clutch of other medical conditions that are linked to obesity. But they are looking at specific pills to fight obesity as people want such pills from their doctor. “There has been a perceptible trend… among upper-income group obese patients who have connections in other countries where these drugs are accessible,” says Dr Anoop Misra, Chairman, Fortis C-DOC Hospital. “Many of these individuals have received recommendations for these drugs from relatives residing in Western countries, where such medications are widely used,” says Misra who is also the Director at National Diabetes, Obesity & Cholesterol Foundation.
Indians are not giving up on the usual tools such as diet and exercise to control weight. But these tools don’t work so well for the obese. Note: All obese people are overweight, but not all overweight people are obese. If you are the average Indian at 5 feet 6 inches tall (So says online data platform Statista, quoting a 2019 survey), and weigh 70 kg, you have just entered the overweight class (body mass index or BMI of 25.3). If you are 115 kg and above at that height, you are obese.
The incidence of obesity is on the rise in India, with data from the National Family Health Survey-5 (NFHS-5) spanning 2019-2021 indicating that 33.2 percent of urban women and 29.8 percent of urban men (aged 15-49) are overweight or obese. This accounts for over 135 million individuals, signifying a significant health challenge. Childhood obesity is particularly alarming in urban India, holding the dubious distinction of having the highest number of obese children globally, exceeding 15 million.
The prevalence of overweight and obesity in children aged 5-19 has surged from 4 percent in 1975 to a concerning 18 percent in 2016, according to the World Health Organization (WHO). These children, if not addressed, will contribute to the growing population of obese adults.
Several factors contribute to the escalation of obesity in urban India, encompassing rapidly changing lifestyles, increased consumption of processed foods and sugary beverages, and a lack of physical activity. Genetic predisposition adds another layer to this complex issue.
While there is indeed a growing demand for weight-loss drugs, medical professionals emphasize the importance of taking such medications under strict medical supervision. Dr. Pradeep Chowbey, Chairman of Max Institute of Laparoscopic, Endoscopic, Bariatric Surgery & Allied Surgical Specialities, highlights the need for patients to adhere to all instructions provided by physicians, including regular follow-ups. Despite this, there's a tendency for individuals, even those slightly overweight, to view these medications as an easy solution to maintaining a desired physique.
The confluence of medical progress and individual aspirations has transformed the fight against obesity into a shared objective involving patients, medical professionals, and pharmaceutical firms.
Various weight loss drugs employ distinct mechanisms (refer to the 'Fighting the Flab' box). For instance, glucagon-like peptide-1 (GLP-1) agonists like Novo Nordisk’s Wegovy/Ozempic (semaglutide) and Saxenda (liraglutide) mimic GLP-1, inducing a sense of fullness and reducing food intake. Phentermine suppresses appetite and increases metabolic rate, aiding in weight loss. Orlistat, such as Roche Pharmaceuticals' Xenical, reduces fat absorption in the gut, thereby lowering calorie intake.
Novo Nordisk, based in Denmark, leads the field with weight management drugs like Ozempic and Wegovy. Eli Lilly from the US offers Mounjaro, a combination of GLP-1 and glucose-dependent insulinotropic peptide (GIP) hormones for weight loss. Vivus Pharmaceuticals in the US developed Qsymia, a combination pill that curbs appetite and boosts metabolism. Roche Pharmaceuticals from Switzerland provides orlistat (Xenical), targeting fat absorption reduction. Orexigen Therapeutics, another US company, offers Contrave, a combination pill addressing brain pathways to diminish cravings. However, these medications come at a substantial cost.
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