ONE of my patients, Rajesh (52), a businessman, is a long-time diabetes patient. Despite being on multiple medications, including insulin, his blood sugar remained unstable. He was constantly fatigued. There was onset of kidney problems associated with diabetes. And he was steadily gaining weight despite being on a balanced diet.

The conventional approach would have been to increase his insulin dose. Instead, after careful evalution, he was put on GLP-1 injections. Over the next few months, the change was striking. His blood sugar levels improved significantly. His dependence on insulin reduced. His kidney parameters stabilised. But most importantly, his energy returned — he felt healthier, more active, and more in control. And he lost weight. But the real gain was his overall health trajectory.

There are thousands of such patients who stand to gain after the recent expiry of patent on GLP-1 drugs (Ozempic/Wegovy), known for their rapid weight-loss effect. This has opened the market for over 65 generic versions by various pharma companies and is expected to bring a drop in prices of these drugs by 50 per cent, and improving their access. Though GLP-1 drugs have been been reduced to only as ‘weight-loss injections’ in public consciousness, these have far more beneficial effects for a variety of medical ailments other than reduce weight rapidly.

How these drugs work

These drugs mimic the effect of GLP-1, a natural hormone released from the intestine after a meal. It signals the pancreas to release insulin, tells the brain that you are full, and slows down the emptying of the stomach. The result — you eat less, feel satisfied sooner, and experience fewer cravings, especially for sugary foods.

GLP-1 drugs are a lab-made version of this natural hormone. Unlike the natural GLP-1 that works for only a few minutes during and post-meal, the lab-made version works for a much longer period, that’s why GLP-1 injections are taken once a week. But beyond mimicking these functions, the drugs also protect the body’s vital organs.

Benefits to other organs

In three major studies published in ‘The New England Journal of Medicine’ — SUSTAIN-6 (2016), SELECT (2023), and SOUL (2025) — when GLP-1 drugs were given to patients with obesity and heart disease or high risk of disease with or without diabetes, those given the drugs had fewer heart attacks, strokes, and even the death rate was less.

Another study called STRIDE, published in ‘The Lancet’ (May 2025) showed that benefits were not limited to the heart patients, as patients with peripheral blood vessel disease also showed improved outcomes.

In FLOW trial, whose results were published in ‘The New England Journal of Medicine’ in May 2024, patients with diabetes and kidney disease showed clear improvement.

In fatty liver disease, which can progress to cirrhosis and even liver cancer — studies such as LEAN (The Lancet, February 2016) and ESSENCE (‘The New England Journal of Medicine’) showed reduced liver fat and improved liver health. Emerging evidence also suggests a potential role in slowing early cognitive decline, including Alzheimer’s disease.

Some ongoing research says that these medicines may reduce cravings beyond food, including smoking and alcohol, pointing to a broader effect on the brain’s reward system.

GLP-1 drugs are not just changing the way how people look — they may be changing how long and how well they live — by preventing damage to the heart, kidneys, liver, and brain before it becomes irreversible.

A word of caution

However, the easy availability of these drugs also raises concern about their misuse for cosmetic purposes. People must understand that these are powerful prescription medicines, and not a lifestyle shortcut or cosmetic tool.

Also, not every patient with obesity, heart disease, or kidney issues needs these drugs. This decision should only be taken by a medical expert, as it is an individualised, evidence-based choice, based on a patient’s case history.

For those using them purely for cosmetic weight loss, a note of caution — the weight loss achieved with these medicines is not permanent. Studies show that once these drugs are stopped, most people regain a significant portion of the lost weight. Moreover, the weight lost is not just fat as some muscle loss also occurs, which can negatively impact long-term health. That is why a healthy lifestyle remains non-negotiable, including:

A balanced, sustainable diet

Regular physical activity

And, importantly, strength training to preserve muscle

These medicines can support the process, but they cannot replace the fundamentals.

What studies show

Large international clinical trials have shown that when people with obesity and high health risks are given semaglutide, there are multiple benefits.

  • The chances of heart attacks and strokes are significantly reduced
  • Kidney damage slows down, especially in people with diabetes
  • Fatty liver disease improves, potentially preventing long-term complications like cirrhosis
  •  Some trials also show that these drugs may even help delay cognitive decline, including conditions like Alzheimer’s disease

— The writer is an endocrinologist, Fortis, Mohali