The year of weight-loss drugs: When health became about thinness, not fitness, again

The use of weight-loss drugs, whose benefits outweigh the risks in those who are on the edge, has unfortunately also created a new sense of inadequacy.

For the past couple of years, weight-loss drugs have been an elite privilege, creating a class system within those battling obesity and diabetes and setting new aspirational benchmarks of what a healthy life should look like. This year, their manufacturers lowered their prices, tapping into a booming diabetes and obesity market in India. Given that the trials of their cascading benefits — being protective of the heart and kidneys — were largely industry sponsored, has the medicalisation of obesity hijacked our understanding of body image?

For starters, a once-a-week jab is seen as a saviour drug that belittles any human effort at weight loss and even makes it unnecessary among those averse to a gym routine. Despite repeated clarifications that the efficacy of the drug is co-dependent on diet, lifestyle corrections, fitness routines, and most importantly baseline fitness and health, it has emerged as the heavenly manna that can melt fat without heaving off the couch, completely disempowering an individual and bartering away their will to take physical charge of their lives.

The obvious fallout has been the Benjamin Buttonish experiments of techpreneur Bryan Johnson, who has built an empire around body obsession, even finding ways of tackling the side effects of drugs, muscle wasting and a droopy face. Be it gene therapy for building muscle mass or the Baby Face shot of a donor-derived fat to restore facial volume, weight loss drugs are laying the foundation of Johnson’s belief that the body is God, giving it agency over the human mind.

Societally, weight-loss drugs “healthified” thinness instead of fitness. Celebrities at red-carpet events wore more translucent dresses in 2025, showing off their age-defying thin bodies. It didn’t matter that their face drooped due to loss of face fat, had deeper wrinkles and that they looked visibly older. Or that the appetite-killing drugs had robbed them of sensory joys. None other than tennis ace Serena Williams was coerced by the “thin and fit” grammar as she promoted a weight-loss injectable as a brand ambassador of a healthcare company. She may have made an informed choice for her health, but she simultaneously propagated the myth that even an athletic and a robustly built person like her needed a jab to feel better about herself.

This equalisation of the cosmetic with the clinical has undone the entire concept of body positivity and acceptance. While body positivity can in no way be used to justify obesity, it does lead to self-acceptance rather than self-abhorrence and helps to demolish stigmas. Defining the body in terms of clinical constructs like BMI may inadvertently reinforce thinness as the only acceptable self-image tool and toss all larger body types to the “unhealthy” basket, who feel extreme pressure to conform, not because they organically want to but because society just thrust a judgmental milestone at them. This has already percolated to the daily economy. Plus-size sections at brand outlets are disappearing fast with a polite suggestion to go online for bigger sizes.

But the price of the drug is the biggest demotivator, with midlifers in the US giving up the medication midway because of the cost burden. Besides, let’s not forget the dark side: The suits against manufacturers about insufficient warning labels about the severe side effects — gastrointestinal issues, muscle wasting and vision problems. A public interest litigation (PIL) in the Delhi High Court has raised concerns about the licences for certain weight-loss drug combinations without India-specific trials, overlooking regional health and genetic factors.

For sedentary Indians, who have a thin-fat problem, meaning they may not be overweight but have belly fat, the use of the drug might lead to severe muscle wasting, which tends to be replaced by more fat. Traditionally, fitness implied strength and overall well-being achieved through physical activity. The use of weight-loss drugs primarily targets fat mass, which may or may not directly correlate with overall physical fitness and functional health. Yet the obsession with drugs seems to take away the human agency we all have.

The writer is senior associate editor, The Indian Express. rinku.ghosh@expressindia.com