Leading clinicians have urged a more holistic, medically supervised approach to Semaglutide use for weight management as the globally successful formulation goes off patent in India. They warned that while the drug is a proven option for diabetes and obesity, it must not be viewed as a shortcut or standalone solution, but as one component of a wider plan that includes structured nutrition, adequate protein intake, strength training and sustained lifestyle change.
The panel of experts included interventional cardiologist Dr J S (Jagdish) Hiremath, diabetologists Dr Sanjay Agarwal and Dr Rajiv Kovil, and senior endocrinologist Dr Vaishali Deshmukh. They stressed that careful evaluation of patient eligibility, comprehensive metabolic assessment and a valid prescription from a qualified physician are essential before starting therapy. Adherence to dosing schedules, dose titration and regular follow-up visits were highlighted as critical to ensuring safety, tolerability and durable outcomes.
“Obesity is a widespread issue in India, with 70% of the population affected in some form. While traditional methods like diet and exercise offered modest weight loss, they were insufficient for individuals with a BMI above 30. The advent of semaglutide provides a promising and affordable solution to bridge the treatment gap. By reducing weight, we can significantly lower the risk of chronic diseases such as diabetes, hypertension, heart disease, and cancer,” said Dr Sanjay Agarwal, underlining the scale of the problem and the opportunity the drug presents.
From a cardiology perspective, Dr Jagdish Hiremath framed obesity management as central to cardiovascular risk reduction. “Obesity is a major risk factor for heart disease, and its management is critical in preventing cardiovascular issues. For patients without heart disease, addressing obesity early can help prevent future complications. In those with existing heart conditions, weight loss through treatments like semaglutide can help mitigate further risks. This drug has shown significant benefits in reducing weight, improving blood pressure, cholesterol, and even conditions like obstructive sleep apnoea and heart failure,” he said, adding that such therapies represent a significant advance in clinical practice but “must be used with due precautions and counselling to provide maximum benefits safely.”
The experts noted that most patients tolerate Semaglutide well, with commonly reported side effects such as nausea or a feeling of fullness usually mild, transient and seen mainly in the initial phase. They emphasised the importance of gradual dose escalation, early counselling on expected effects and close monitoring to pre-empt dropouts related to poorly managed adverse events. Ongoing clinical engagement and routine follow-ups were described as essential to identify and address concerns around adherence, tolerability and patient experience in real time.
Highlighting the mechanistic depth of the therapy, Dr Rajiv Kovil described Semaglutide as a “significant breakthrough” that helps tackle the underlying fat distribution driving metabolic disease. “Semaglutide marks a significant breakthrough in our ability to address the root cause of obesity and diabetes, the wrong deposition of fat in organs like the liver, pancreas, and kidneys. With each percentage of fat reduction, we see a meaningful modification in disease outcomes. By reducing weight by 10-15%, we can improve conditions like fatty liver, diabetes, osteoarthritis, and even help patients reduce their medication requirements. This drug not only reduces weight but also offers substantial protection to vital organs like the liver, kidneys, and heart,” he said.
Dr Vaishali Deshmukh underscored the need to treat obesity as a chronic, multi-organ disease rather than a mere lifestyle issue. “Obesity is not merely a lifestyle issue but a disease affecting multiple organs in the body. We must focus on adipocyte or fat health, similar to any organ health and metabolic evaluation must be done along with BMI and body composition assessment to understand the true impact of obesity. Semaglutide, when combined with lifestyle changes, can help manage weight more effectively, especially when traditional methods stop working or plateau down,” she said, calling the drug “a powerful tool” against obesity and related conditions such as diabetes, heart disease and hypertension when used judiciously.
The panel also drew a clear distinction between the innovator Semaglutide and emerging generic products. They pointed out that the original molecule is a biologic supported by robust data from nearly 50 clinical trials across multiple indications and outcome studies, and has been used by more than 25 million patients worldwide over more than a decade. By contrast, generics being launched are synthetic or chemical entities, underscoring the need for clinicians and patients to pay close attention to evidence, quality and regulatory status when considering alternatives.
Overall, the experts called for strong patient education and realistic expectation-setting as the formulation goes off patent, cautioning against unsupervised use or demand driven solely by rapid weight loss goals. By embedding Semaglutide within a structured, monitored and personalised care plan, they argued, clinicians can maximise benefits, minimise risks and support better long-term cardiometabolic health and quality of life.
