Once upon a time, this family’s idea of “portion control” meant who would get the last scoop of shrikhand, that luscious, creamy Indian dessert that they never missed. Till they tilted the scales so much that all of them were not only overweight but had developed diabetes or landed in the stubborn prediabetes phase, when blood sugar levels refuse to go down to normal. Then they embarked on a quest to shed the extra kilos and get healthy with a little help from an unexpected ally — Semaglutide, the weight loss-cum-diabetes treatment drug. Now, this Surat-based family has become a poster parivaar of how medication can be a jetpack and set you on a determined course of good health.
The patriarch, aged 60, is no longer insulin-dependent and has resumed walks, much brisker now that he feels lighter. His wife, sons and daughter-in-law have shed between 15 and 20 kg in just six months. While the parents managed their weight with Rybelsus, the oral form of Semaglutide, both their sons and daughter-in-law chose the faster-acting injectable, Mounjaro (Tirzepatide), procuring them directly from the US. Semaglutide essentially mimics a hormone that stimulates the pancreas to produce more insulin, in turn lowering blood sugar, reducing craving and slowing digestion. All these mechanisms keep you satiated and prevent you from overeating, ultimately leading to weight loss. Tirzepatide decreases food intake and modulates fat utilization.
All along, their attending physician, Dr Rajiv Kovli, a diabetologist at Zandra Healthcare and secretary at the United Diabetes Forum, cautioned them that while the medication could give them a head start, it should not be misconstrued as a miraculous and permanent weight loss remedy. “While these drugs may facilitate initial weight loss, sustaining progress beyond a certain point necessitates comprehensive dietary and lifestyle adjustments. These medications can contribute to a weight reduction of up to 15 per cent, which is highly motivating, while simultaneously aiding in the mitigation of sugar levels, reduction of liver fats and addressing other chronic ailments intertwined with obesity. They also serve to enhance organ functionality,” he says.
Each family member has had their own weight loss journey with the help of the drug. The father, who runs a pan-India air conditioning installation enterprise, was diagnosed with Type 2 diabetes in his 40s. But prioritising work challenges meant he could not adhere to an exercise regimen or manage his blood sugar levels. He became insulin-dependent, administering the injections himself. However, his blood sugar levels hovered around 300 mg/dl while his weight would not just budge from 94 kg. Which is why Dr Kovli, whom he consulted at the beginning of the year, put him on a regimen of Rybelsus, beginning with a one-milligram dose and later going up to seven milligrams. “I lost around four kg within the first month without experiencing any discernible side effect. I became confident and over the next six months, I lost 12 kg. My blood sugar level dropped dramatically to 115. Now I do not need insulin injections and am free of the multiple pinpricks,” he says. Having lost 25 kg since starting the regime in February, he is motivated enough to fulfil his daily quota of exercise and not let that waistline bulge.
At 5.4 ft tall and weighing 90 kg, the mother had tried every weight loss trick in the book except address it scientifically. Over the course of a decade, she had explored dietary detoxification, herbal supplements and Ayurvedic rejuvenation therapies like panchakarma except focus on an exercise regime that would have helped her deal with anxieties. The diagnosis of prediabetes was the last straw and she decided to take Semaglutide, noticing its positive impact on her husband’s sugar control and weight management. She was prescribed a 3 mg dose in March and simultaneously incorporated yoga into her routine. As matriarch, she decided to correct the family diet. “I have now reduced ghee and increased legumes and pulses in our daily meals. Being rich in protein and fibre, they keep me feeling full for a longer time, delay digestion and avoid blood sugar spikes,” she explains. In the past six months, she has shed around 10 kg.
But it was the couple’s oldest son, who reached the tipping point. Travelling extensively for work and having mostly hotel food, he weighed an unwieldy 123 kg at 39, finding himself in a prediabetic condition. “I would heave and pant while climbing a single flight of stairs,” he says. Dr Kovli put him on Mounjaro as the family had the ease to procure it from the US. This injectable drug can address both weight and Type 2 diabetes by improving blood sugar control. Since commencing this treatment, the oldest son’s body weight has plummeted to 113 kg, reviving his energy levels. He can now climb five floors without gasping for breath and is determined to be a responsible father for the sake of his daughter. “Now I wake up early at 6.30 am and dedicate an hour to swimming,” he says.
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His wife was least expected to be overweight as she kept to a daily exercise regimen. But being a foodie meant her weight plateaued at 75 kg. “I am just 5 ft tall and had easily developed prediabetes,” she says. That’s when she began her weekly injection dose with her husband. Though she experienced some nausea in the initial stages, the discomfort ebbed away soon after and she now weighs 64 kg. She has revamped her daily routine, has a healthy breakfast, snacks on fruits between meals, has a lunch rich in green vegetables at 1 pm and dinner by 7 pm. She doesn’t eat anything after that and surprisingly experiences no lingering hunger pangs.
The physical transformation of his family members was enough motivation for the youngest son, 36, who was obese at 130 kg and had been grappling with high blood pressure and prediabetic conditions. “I saw my father weaning himself off insulin and now I have lost 25 kg, have given up on pizzas and am into salads.”
The Surat family’s story is a microcosm of our at-risk population and if an ICMR-INDIAB study is to be believed, the conversion of prediabetes to diabetes among Indians is faster than any population with 15.3 per cent of Indians already in the prediabetes stage. Dr Kovli says he started with the lowest dosage of drugs, which latest research shows also leads to a 20 per cent risk reduction of heart attacks. He’s looking forward to the next level of glucagon-like peptide-1 receptor agonists (GLP-1-RA), which can suppress appetite, regulate stomach movements and reduce the hormone glucagon, which tends to be elevated in people with diabetes. “Medication just pulls you out of the trough, you still have to walk your own path,” he adds.
