Even pills ask you to diet and exercise, India must rethink its shortcut to health
Partner Biplab Lenin and Associate Anam Chowdhary, Cyril Amarchand Mangaldas highlight how CDSCO’s recent approvals for GLP drugs like Ozempic and Mounjaro redefine chronic disease management by mandating lifestyle changes alongside medication
In a move that signals a fundamental shift in how we approach chronic disease management, the Central Drugs Standard Control Organization (CDSCO) has recently approved several glucagon-like peptide (GLP) drug, including the now-famous Ozempic and Monjaro, for treating Type 2 diabetes and obesity. Novo Nordisk India received approval for Semaglutide Injections (Ozempic), Eli Lilly And Company secured the green light for Tirzepatide, and Cipla Limited obtained authoriSation for Dulaglutide, among others. But here is the twist that makes this approval particularly noteworthy – the approval has given the green signal to GLP medication with a clear and unambiguous caveat, which one could say is also a wake-up call – watch your diet and start moving! Previously, numerous fixed-dose oral antidiabetic drugs, including Sitagliptin Phosphate IP and Linagliptin + Metformin Hydrochloride IP, etc., have also been approved with an identical caveat.
Dawa, dua, and now, diet and exercise too
CDSCO has explicitly stated in its approved drug listings that these GLP medications can effectively control Type 2 diabetes and obesity only when consumed “as an adjunct to diet and exercise” or “as an adjunct to a reduced calorie diet and increased physical activity“. This caveat from India’s apex drug approval authority is particularly significant because it fundamentally challenges the notion that medicines alone can serve as the ultimate refuge from chronic diseases. Instead, it points toward a more holistic approach where pharmaceutical intervention is combined with balanced nutrition and regular physical activity for proper disease and weight management.
For a nation which has heavily relied on the ‘miracles’ of the pill and the phrase “dawa aur dua”, this represents an uncomfortable reality. Ironically, even as gyms sprout up on every street corner and the wellness market floods consumers with products promising to reverse years of poor lifestyle choices, Indians have been slow to embrace genuinely healthier habits. Weight-loss medications and other drugs still remain as the most attractive choice. With CDSCO’s explicit requirement that GLP drugs must be accompanied by lifestyle modifications to deliver full benefits, exercise and dietary changes are no longer optional extras; they are essential components of treatment.
The case for a holistic approach to disease management
The regulatory authority’s strong emphasis on lifestyle modification underscores an important reality – GLP medicines can suppress appetite, but they cannot teach patients to choose dal over deep-fried pakoras or fresh fruit over packaged chips. They can help reduce portion sizes, but they cannot magically transform calorie-dense thalis into nutritionally balanced meals. Similarly, while GLP drugs may not preserve muscle mass or build cardiovascular endurance. Without regular physical activity, patients risk trading excess fat for physical frailty, and this could hardly be an ideal outcome. In a country where sedentary office jobs, endless traffic jams, and Netflix marathons dominate urban existence, this mandated coupling of exercise with medication is both practical and profoundly symbolic. It shatters the illusion of the effortless quick fix and acknowledges that genuine health requires genuine effort.
Conclusion – Reimagining healthcare as a team sport
This paradigm shift has significant implications for how healthcare is delivered. Doctors can no longer simply prescribe a GLP drug and consider their job done. They must now counsel patients on lifestyle choices, dietary patterns, and exercise routines. In this new landscape, the expertise of dietitians and physical trainers becomes indispensable. Patients seeking maximum benefit from GLP medications will require guidance from a multidisciplinary team – physicians, nutritionists, and fitness professionals working in concert.
This integrated approach to healthcare and wellness, where medical professionals collaborate across specialties to achieve optimal disease and weight management outcomes, may well represent the future of treatment in India. It is a future where the dining table and the walking track matter just as much as the hospital and doctor, and where true health is recognised as something that cannot be purchased in a pharmacy, but must be earned through consistent, mindful choices.
