Obesity is not just a personal struggle—it is a systemic failure. This World Obesity Day, the theme “Changing Systems, Healthier Lives” underscores an urgent reality: blaming individuals is futile when the root causes lie in our environment, policies, and food systems.
For decades, sedentary lifestyles, ultra-processed foods, and urban designs that discourage physical activity have fuelled a global obesity crisis. Yet, responses remain fragmented and insufficient. Governments must act decisively—tighten regulations on misleading food marketing, ensure schools and workplaces provide nutritious meals, and invest in active transportation infrastructure. The healthcare sector, too, must shift its focus from reactive treatments to proactive prevention through early interventions and widespread public awareness.
Industries bear a crucial responsibility. The food and beverage sector must reformulate products, embrace transparency, and eliminate predatory advertising. Employers should create healthier work environments by integrating wellness programs and ergonomic best practices. Education systems, too, must prioritize nutrition literacy and physical well-being from an early age.
True progress hinges on systemic transformation, not individual willpower. By overhauling policies, industries, and communities, we can build a future where healthy choices are not a privilege, but a norm. Change the system—change lives.
In an exclusive conversation with The Interview World at Illness to Wellness, an interactive session on Obesity and its Adverse Impact on Health, organized by ASSOCHAM, (Prof.) Dr. Nikhil Tandon, Professor and Head of Endocrinology and Metabolism at AIIMS New Delhi, sheds light on obesity’s profound impact on health, lifestyle, and overall well-being in India. He also examines the risks associated with semaglutide, particularly its widespread off-label use for type 2 diabetes, obesity, and weight management. Additionally, he explains why carefully weighing the benefits and risks of such medications is critical for public health. On this World Obesity Day, Dr. Tandon delivers an essential message—one that demands attention.
Here are the key takeaways from our compelling conversation.
Q: How is obesity affecting the health, lifestyle, and overall well-being of people in India?
A: Obesity triggers a cascade of health complications, far beyond mere cosmetic concerns. It fuels respiratory illnesses, heart disease, fatty liver, high blood pressure, elevated blood glucose, poor cholesterol, and musculoskeletal disorders. Its impact extends across all organ systems, making urgent intervention imperative. We must not only treat obesity aggressively but also take decisive steps to prevent its onset, ensuring healthier aging and overall well-being.
Q: Given the impact of obesity on the health and well-being of people in India, what are the potential side effects of semaglutide, especially with its widespread off-label use for treating type 2 diabetes, obesity, and weight management?
A: I speak with confidence on this subject because I served on the global expert panel for both oral and injectable semaglutide. My access to global data and direct involvement in clinical studies provide a solid foundation for my insights.
First, every medicine has side effects. It’s unrealistic to expect otherwise. When evaluating any drug, we must approach the discussion logically and reasonably.
Second, the risk-to-benefit ratio determines whether a medicine remains viable. If the benefits significantly outweigh the risks, we accept them. However, when prolonged exposure reveals an unacceptable shift in this balance, we reconsider its use. Many previous medications failed this test over time.
Third, regulatory standards for diabetes drugs have evolved. Years ago, concerns arose over a particular diabetes medication, prompting the U.S. FDA and other agencies to mandate long-term cardiovascular outcome studies. Now, all new diabetes treatments undergo rigorous monitoring for at least four to six years to assess potential cardiovascular risks. Current data on these agents reassure us that they do not cause cardiovascular harm.
Concerns have surfaced regarding ulcers, but most side effects linked to these medications are reversible. If a patient experiences stomach discomfort or other mild issues, they can simply discontinue the drug without lasting consequences. The real concern lies in irreversible risks—damage to the heart or brain that persists even after stopping the medication. As of today, no data suggest any structural or functional harm of this nature.
That said, medicine evolves with time and continued observation. While five-year exposure data offer reassurance, ongoing vigilance remains essential. We must base our decisions on the best available evidence while remaining open to new findings.
Q: Considering the impact of obesity on people’s health in India and the potential side effects of semaglutide, what is the rationale behind measuring the benefits and risks of medicines for the general population?
A: The benefits we’ve discussed are supplementary. If I aim to lower cholesterol, I prescribe a statin. If this medicine also improves cholesterol levels, that’s an added advantage—a welcome bonus.
Most of the data come from patients with diabetes, where concerns extend beyond cholesterol to kidney and heart complications. These risks are real, and I highlight them proactively. Many patients struggle with medication tolerance, and that holds true for any medical intervention. Surgeons, too, acknowledge that while some patients recover seamlessly from bariatric surgery, others experience persistent issues.
No medicine guarantees absolute benefits without risks. However, every approved drug undergoes rigorous, multi-layered clinical trials before reaching the public. When prescribed by doctors, medicines are intended to treat, not harm. Side effects often stem from individual tolerance, not a fundamental flaw in the drug itself.
Q: What message would you like to share with the public on World Obesity Day?
A: Prevention, along with proactive secondary prevention, remains the most effective strategy against obesity. We must take decisive steps to stop it before it starts. However, for individuals who are already overweight or obese, intervention must be swift and comprehensive. A multidisciplinary team—including physicians, nutritionists, fitness experts, and mental health professionals—must collaborate to provide personalized solutions. Their combined expertise ensures patients receive structured guidance on sustainable weight loss, proper nutrition, and lifestyle modifications.
Beyond shedding excess weight, the goal is long-term management, empowering individuals to maintain a healthy weight and reduce their risk of associated health complications.
