One patient loses 20 kg, and rediscovers the joy of dressing up and attending family functions. Another sheds only a few kilos but sees better blood sugar control. Why can GLP-1 medicines produce such different experiences?

In this episode, host Srirupa Ray, a deputy news editor with TOI, speaks to Dr Ambrish Mithal, group chairman, endocrinology and diabetes, Max Healthcare, Delhi about the promise, limitations and misconceptions surrounding GLP-1-based treatments.

Dr Mithal explains why their significance extends beyond the weighing scale, discussing their role in diabetes management and the evidence for benefits involving the heart, kidneys and liver. He also explores how these medicines influence appetite, fullness and cravings, helping some patients quieten the constant ‘food noise’ that shapes their relationship with eating.

But who actually needs them? And who should avoid them or undergo closer assessment? The conversation addresses medical supervision, gastrointestinal side effects, realistic weight-loss expectations and why taking injections briefly before a wedding or another event is ill-advised.

Drawing on patient accounts, Dr Mithal discusses why weight-loss responses vary, why people with diabetes may lose less weight, and why improved metabolic health can matter even when the scales barely move. He explains the importance of personalised nutrition, adequate protein and strength training, alongside questions about long-term treatment, maintenance doses and weight regain after stopping.

For anyone considering these medicines — or hesitating despite a doctor’s recommendation — this episode offers a perspective grounded in science rather than social-media hype.

Chapters:

02:21 - Why GLP-1 drugs are changing chronic disease treatment

04:48 - Who really needs these drugs — and who is chasing a cosmetic fix?

08:57 - The problem with taking them before an event, then stopping

10:30 - Behind the book, ‘The Weight Loss Revolution’

13:32 - Beyond weight loss: Benefits for the body and emerging brain research

18:02 - A patient’s story: Losing 20kg and rediscovering confidence

19:43 - Who should avoid these drugs or seek closer assessment?

22:03 - How GLP-1s work: Gut effects, cravings and ‘food noise’

26:02 - Lifelong treatment, maintenance doses and stopping medication

28:42 - Setting realistic weight-loss expectations

30:00 - Fewer kilos lost, better sugar control: Another patient’s experience

32:36 - Why some people lose more weight than others

35:15 - Why nutrition, protein and strength training still matter

37:56 - Quality of life, tolerating side effects and advice before starting on GLP-1