GLP-1 is used to control obesity.
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As the world awaits the launch of 70 different molecules of ‘weight loss drugs’ over the next 5–10 years, the president of the International Diabetes Federation, Peter Schwarz, is still sticking by the old faithfuls of diet and exercise to regulate metabolic activity.
On a day’s trip to Chennai to launch the new International Diabetes Federation’s Global Physical Activity Consensus Group, Dr. Schwarz spoke at length about what the glucagon-like peptide-1 (GLP-1) therapies have been able to achieve, but went on to bring up the cost factor, and reinstated that forsaking lifestyle-modifying activity will be detrimental.
He told The Hindu: “A big issue for me is equity in access to diabetes care. The new GLP-1 class of drugs comprises brilliant molecules that have very good action, but they are also very expensive. If you look at diabetes from a global scale, in some countries, this will make diabetes care 22 times more expensive. And from a public health perspective, I believe it’s not sustainable.”
“I think a big, big fraction of our people living with type 2 diabetes could reach similar effects by significantly improving physical activity because this is what we are lacking over the last 100 years; and adopting fasting.” The IDF will issue a guideline in April 2027 about 19 different fasting styles for diabetes prevention and diabetes therapy, he adds.
In terms of physical activity, the new consensus group headed by Anjana Ranjit of Dr. Mohan’s Specialties Diabetes Centre will soon come out with an active guideline to help people leverage physical activity in daily life. “Every muscle cell you gain by using physical activity helps you to stay healthy, helps you to become healthy, helps you to control your diabetes and you can literally walk diabetes away,” Dr. Schwarz says.
V. Mohan of Madras Diabetes Research Foundation agrees: “There is no doubt that these drugs are wonderful. There are GLP-1 receptor analogs, dual analogs, and now triple and quadruple analogs are coming up. The weight loss is profound – up to 20 kg. With a triple agent, not yet in clinical use, studies show that the weight loss is equal to bariatric surgery.”
The effects are dramatic: Weight loss, a drop in HbA1C, and a reduction in liver and pancreatic fat. People might think that just taking a weekly injection can replace diet or exercise. Dr. Mohan interjects: “Diet and exercise are paramount, and only when those fail, do you put a patient on GLP-1. Even the WHO’s recent guidelines on the subject insist on continuing lifestyle modifications.”
Dr. Anjana says to arrive at a consensus on drawing up guidelines for physical activity, one needs to zero in on a bouquet of activities that will be a culturally acceptable form of physical activity to help control and prevent NCDs. Armed with her experience running a high-intensity interval training dance-based programme, Thandav, targetting women, she says the goal is to create active communities and give institutions and governments tools to prioritise activity.
Published – December 05, 2025 10:05 pm IST
