He highlighted that while the drug helps reduce body weight, maintaining the results requires motivation and willpower.
Category
🗞
NewsTranscript
00:00So, this session is very relevant, planned just a couple of sessions before lunch.
00:09Golu, Gappu, Hathi, Motu, Tuntun, Fatty, Tank, Solid, Rolu, Laddu – cute nicknames for
00:23people suffering from being overweight.
00:26But would you tease people suffering from cancer, autoimmune, Bell Palsy?
00:34No.
00:35It's because for so long, obesity has been treated like a character flaw, a lack of willpower,
00:43a sign of laziness versus a disease.
00:48Even World Cup cricket captains are not spared.
00:53Finally, there is a narrative to recognize that the rise of obesity in the rates that
00:59they are going, that we will have one billion people in 2030, cannot be a global loss of
01:07willpower.
01:08Are we ready to cause… call it a disease and prevent it?
01:14To talk about this and more, I have the great pleasure of introducing the MD of Novo Nordisk
01:21India, a global healthcare company recently in the limelight as makers of Ozempic and
01:28Vigovi and if you do not know what Ozempic is, please check your pulse because it has
01:34been setting the pharma market on fire.
01:40It is the medicine or the injection that people are taking to lose weight without much pain.
01:48It's also known as the skinny pen and it's leading to dramatic weight loss.
01:54What used to be the celebrity's best kept secret is now out in full glamorous glory
02:02on the red carpet.
02:04What we are seeing is I think a historic inflection point in the treatment of obesity.
02:11So now, can I please welcome Vikrant to help me answer these questions and more.
02:31Vikrant, your company has taken center stage in calling obesity a disease and it has been
02:38approaching obesity for the last twenty-five years.
02:42What are your main insights or takeaways?
02:44Vikrant Chauhan Thank you very much Kelly and I was there
02:48in the last to last session where you know Guruji talked about or Swami Giri talked about
02:55shanti, sabko chahiye and I think swast bhi sabko chahiye.
03:03These are two things which everybody aspire.
03:06Now obesity, when you actually look at it, forty percent people are either obese, overweight
03:14or having a central or a visceral obesity.
03:18Now it's so common that it's very uncommon to see somebody having the right BMI.
03:26Something which is so common, how that can be a disease, right?
03:29Okay.
03:30Kelly Cervantes But you look like somebody who has a pretty
03:31good BMI unless you are on ozempic.
03:34Vikrant Chauhan I do have a good BMI but let me tell you it
03:38is a phenomena called as thin fat Indian.
03:42So I do look thin but bring a person who is sixty-seven kg weight, who is a Caucasian
03:49European and if you measure the fat which is abdominal or a visceral fat, I will probably
03:56have twenty-three or twenty-four percent fat while a Caucasian will have only sixteen
04:04or seventeen percent fat.
04:06So that's basically a little bit of a genetic predisposition.
04:09So when you look at it, about it, calling it as a disease and it's not only me who is
04:14calling, it's the WHO which declared in 1994, it's also US, Canada, UK, many of the governments
04:23actually declared it as a crisis, as something which is a disease.
04:30Now disease is something which is an abnormality.
04:34This is a metabolic abnormality with excess fat and adiposity.
04:41This if it was as easy as an energy balance like you eat less and you exercise more or
04:49you exercise more and eat less, then I guess all of us would be in good shape and size.
04:57I'm very sure, raise your hand, who would have struggled by keeping the weight, at least
05:02I tried losing my weight one kg, believe me, I try, I lose in seven days one kg and it
05:09takes me only one day of partying and it comes back.
05:14So it's like something more than just an energy balance.
05:18It's a phenomena.
05:19We also say, is it a brain disease?
05:23Because people don't want to eat, but then they will eat.
05:29Now we have a lunch after this session, right?
05:32Everybody…
05:33You'll be watching everyone's plate, right?
05:35Everybody will count their calories, I assure you that.
05:38They will be taking it, they know that they should take this or not take this, but I'm
05:43very sure the hedonic pleasure of eating will take over and people who are designed
05:51to eat will eat, people who are not designed to eat will not eat.
05:57So that is why it's not the phenomena of just an energy balance, satiety or hunger, it's
06:02much more than this.
06:03It's a ghrelin, it's amylin, it's GLP-1, it's somewhere in the brain hypothalamus, it's
06:10a mix.
06:11So we call it…
06:12Believe me, we call it blood hemostasis is far more easier than the weight hemostasis.
06:20We know when we get cut, we get a clot, that's the way, blood hemostasis.
06:26But when you really look at the weight hemostasis, it is extremely difficult to control.
06:35So are you saying that these are internal cuts of some kind which lead us to eat more?
06:42Yeah, see, if you go to the prehistoric, you know, era, we were all designed in terms of
06:51going and going for hunting, getting our food, right, and storing that food also.
06:57You know that food was scarce.
07:00It was… the famines were very, very all around the world, specifically in India.
07:06We have this something called as thrifty genotype.
07:10And now when with the urban lifestyle, with the green revolution, food is actually becoming
07:16cheaper and cheaper.
07:17If you see the inflation of most of the commodities, you will find that the food has one of the
07:23lower inflation.
07:24It's not that inflation is not there, but lower inflation.
07:28Eating food is much more cheaper than anything else.
07:32Now when people are eating, it's not something which is in their control.
07:38It's like smoking.
07:39When they are smoking, it's not something they can stop on their willpower.
07:44You just now said, one billion people cannot be losing the willpower, right?
07:49So something beyond the willpower, something beyond the energy balance, something beyond
07:57normal weight hemostasis, which happens, we just distort the metabolic state of a human
08:09being and because of this, the weight gains.
08:12So is our lifestyle basically working against us?
08:15Because one of the things that they say is good for weight loss and it's been said in
08:22ancient Indian health texts as well, is that eat with the sun, right?
08:27Sunrises, sunsets, lots of people want to avoid dinner.
08:30How do you meet people?
08:31How do you entertain?
08:32What do you do?
08:33So is our lifestyle working against us and what do we do about that?
08:37Actually, not only lifestyle, I think we say the Kayanath is working against us, right?
08:43From getting up, you know, in the air-conditioned home, when you get out of the car, get out,
08:51you are actually in the car, again in an office, you are actually sitting, good lunches,
08:57come to the Bangalore, I am actually sitting in Bangalore, IT city, 81% people have got
09:02central obesity or obese because they are coding all the time, they have got fatty liver.
09:09So everything is against the nature of the old human being, which was basically hunting.
09:19The moment we actually shifted from the hunting to agriculture economy and could produce from
09:24the same hectare, from the same acre, rather than 10 kg grain, we could able to produce
09:3150, we could able to produce 100, we could able to store at our home, similarly we could
09:38able to store in our body also for that particular rainy day.
09:43So I would say that yes, it's getting up and eating with the sun, I think it just is
09:52against the today's lifestyle, you know, that is why I would say that fighting against obesity
09:59is not as simple as actually everybody think.
10:04So one of the things, this question was further on, but since you've raised this idea that
10:10we were hunters, so we were active, right?
10:13One of the criticisms of the medicine is that it actually doesn't change people's lifestyle
10:19habits because it makes it easier for you to lose weight without exercising and without
10:25actually fixing the type of food you are eating, though it does restrict the quantity of food
10:31you can eat, right?
10:32So how do you respond to that criticism?
10:36Because it's not actually, the medicine is not going to take us back to a hunter's style,
10:41lifestyle.
10:42I don't think so, it's a criticism.
10:46I think it's a very important element, lifestyle, exercise and diet is actually very integral
10:54part of human being, I call it ABC, attitude, behavior and choices, they are also very important
11:05determinant along with this medication.
11:09This is not a magic pill, Kelly.
11:12This is not an excuse that I can party and I can take an injection.
11:17This is actually a medicine when you cannot change your weight and you are obese from
11:24simple diet and exercise, then this medicine comes as a rescue.
11:30This medicine, what it does is when you are actually hungry, then what happens?
11:37Your metabolic rate also decreases, right?
11:41And when the metabolic rate is also decreasing, you actually feel more to eat.
11:47Now this medication comes and says to the brain that please don't eat.
11:54This actually reduces the gastric motility of the food.
11:58So a sense of fullness actually comes across.
12:01So when this comes, it just helps in terms of weight reduction.
12:06So it is actually a part and parcel along with diet and exercise.
12:11It's not something, we don't say that it is something you can say, it has to be abused.
12:19So from what I've read, you need to have a BMI index of over 30 to qualify for Ozempic.
12:31And at that weight category, you have a very high fat content.
12:36And again, one of the concerns with the use of Ozempic is that it's an insulin sensitizer,
12:44so it leads to muscle waste.
12:46And as a result, you lose muscle and then, okay, you've lost weight, but overall now
12:53you have even more fat than you started off with.
12:57How do you respond to that?
12:59See when you try to lose weight, even with aerobic exercise, like if you run, you know,
13:07of course when you lose, you lose fat and you also lose muscle, right?
13:14Similarly with this medication also, when you are actually losing, you are losing because
13:19what's happening is because of this medication, it's stopping you to eat.
13:25So that means you will also lose muscle.
13:28Muscle loss is a phenomenon which is to the tune of 30 to 40%.
13:33And that muscle loss is a part of it.
13:35But what is very important is the patient should be in consultation with nutritionist,
13:41with a doctor, because nutrition is also a very integral part of it.
13:46Macronutrients, micronutrients, they have to be taken care.
13:50Again, medicine is not just alone in this game.
13:55When somebody is going for weight loss, it's a 360-degree approach along with doctors and
14:01patients, and it has to be also individualized, and it has to be very patient-centric.
14:07It's not something that somebody can just go to the pharmacy and get this and do whatever
14:13and take this injection and can then further blame this injection, you know, for weight
14:18loss.
14:19I think nutrition is very important part of it, diet is very important part of it along
14:24with this injection.
14:26Suppose a person is losing muscle, then of course they should be taking a little more
14:29higher protein diet, and then their muscle loss will be truncated.
14:35So one of the… lot of celebrities don't talk about being on Ozempic, and this is one
14:42of the concern areas, I'll come back to that.
14:44But what I want to ask you is that, does that mean that when you are taking the medicine,
14:50you should also be taking in a lot of supplements and a lot of vitamins to then counter the
14:55dramatic weight loss and loss of nutrients?
15:00I think the answer which I can give is not all the patients are same, right?
15:10And it is basically somebody might have a B-complex deficiency, they might just have
15:16to take B-complex.
15:17Somebody having an osteoporosis, then they might have to take vitamin D. So they have
15:23to supplement with their individual condition.
15:26Obesity most often doesn't represent alone.
15:30Obesity often represent with other comorbidity conditions like hypertension, diabetes, fatty
15:38liver, right?
15:40Even the brain disorders, cardiovascular disease, osteoarthritis, you know, and infertility.
15:48So it is often present with many of the comorbid situations.
15:53Many of the time, 50% of the people have got hypertension.
15:57Can you imagine?
15:58Osteoarthritis is again, range of 50% people have got osteoarthritis.
16:0321% people have got diabetes along with obesity.
16:07So it's never alone.
16:09So it has to be taken individually with the patient and of course, many of the time, the
16:14nutrition supplement might be required.
16:17So actually, this is one of the things that people are saying that this medicine doesn't
16:20just lead to weight loss, but it can also solve multiple other problems that you're
16:24facing.
16:25It is now being seen as a solution to a lot of neurological diseases, addiction, heart
16:32attacks, cardiovascular problems.
16:35Are some of these claims exaggerated like it's just becoming like the new miracle drug
16:39for everything?
16:40No, well, first of all, it is actually definitely not a miracle because I think there are evolutions
16:47which are happening even in the therapy.
16:49There are definitely going to be more and more and better and better medications.
16:54Science as of today is known and that is what is available.
16:58Now when we look at this particular disorder and could you please just focus on the question
17:06what exists?
17:07Yeah, so the question that I'm asking is that when you, even I've forgotten the question
17:13now.
17:14We both need to take Ozempic so neurologically we can be better.
17:20It's a cure for many of the disease.
17:23So let me tell you that obesity is the precursor or the reason directly or indirectly for 229
17:34diseases from head to toe, including depression, anxiety, gout, osteoarthritis, thyroid, CVD,
17:46you know, diabetes, hypertension.
17:48You name it and infertility.
17:50Now this independently is one of the risk factors.
17:55So when you take, when you try to reduce weight and we have seen when you reduce even 5% weight,
18:04your glycemic level reduces.
18:07The blood pressure reduces with 10% you can actually delay and avoid type 2 diabetes.
18:16You can avoid fatty liver.
18:19At 10 to 15% of the weight loss, you can actually start looking at a little bit remission of
18:26type 2 diabetes.
18:27Are you saying that most people here should be taking this medicine?
18:31No, I am not.
18:33But what I can definitely say is that we were not knowing how much the demand could be.
18:39We are actually, Novanodisk is basically the powerhouse of protein chemistry.
18:44For 100 years, we have been manufacturing insulins and we definitely take pride that
18:49every second person on earth, they take Novanodisk insulin.
18:53And it's not a new molecule, by the way.
18:56It's GLP-1, the class which is there, it is actually 30 years old.
19:01So it is not something new.
19:03It might be new in the arena in terms of when people know about it because some of the celebrities
19:09have made it famous.
19:11But it is a class which is there for last 30 years.
19:16The semaglutide injectable actually is as old as six to seven years in the market.
19:22So it's not something new.
19:24In India, we launched oral semaglutide that itself is now three years old.
19:29So it's not something which is actually coming just around the corner.
19:34But it's a molecule which is actually quite old, quite established in terms of getting
19:39on to the treatment first for diabetes.
19:42And then we saw the result in obesity.
19:45And that result, when it came on obesity, we were surprised that the demand was much
19:52more higher than what we actually thought.
19:56We should have calibrated that what kind of a demand is going to be there when one billion
20:02people are getting affected by obesity, you know, and at least an overweight condition.
20:08And I think demand is...
20:10So this is one of the things that is happening.
20:14A lot of celebrities are taking the medication, but not a lot of them are talking about it.
20:20There's still a stigma about taking the medication and losing the weight.
20:25It's seen sort of cheating.
20:27Some of the visuals you're seeing behind us are celebrities who've actually admitted to
20:31using the medicine.
20:33We have a whole lot of celebrities that we think may be using the medicine, but they're
20:37not talking about it.
20:39Why is this medicine seen as cheating?
20:42When we take statins or we take medicines for controlling diabetes, it's not seen as
20:48cheating.
20:50Maybe one of the reasons could be they just want to pat their back that they have got
20:53the fantastic genes, you know.
20:56And sometimes, you know, people just want to say that my genetic pool is coming much
21:00more stronger.
21:01I appreciate you actually coming out and talking about your own story, you know, and
21:08how you have struggled with the obesity in terms of...
21:12It is never easy in terms of losing weight, you actually come back very, very fast because
21:19losing and coming back is a phenomena we call it obesity cycle.
21:24And probably people who are overweight, they actually try at least four times in a year
21:31to lose weight.
21:33But seldom, they actually achieve that.
21:36So, that's one of the things about weight loss, right?
21:40And which is what I wrote about many years ago, but I'm not talking about it anymore,
21:44is that you yo-yo diet and most people here would have been on a diet to lose a couple
21:48of kilos and then maintained it for a little while and then put it back.
21:51What is the research that you have on relapse and does your medicine prevent relapse?
21:59I think relapse is the phenomena which is there with most of the metabolic disorders.
22:07I'm sure that many of you who can relate with diabetes or hypertension or thyroid, when
22:15you don't take medication, what happens?
22:18Basically, it comes back.
22:20Your T3, T4, TSH will actually come.
22:26Your diabetes blood sugar will increase if you don't take your medication, you don't
22:29take your insulins.
22:31And similarly with hypertension.
22:34So likewise, in this disorder also, when actually people try to control with diet and exercise
22:41and I think the success rate is not more than three to six percent in terms of reduction
22:46of the weight with diet and exercise, though it is very, very important.
22:50It comes back because it's a catabolic stage.
22:54So body reads very simple.
22:56Body has lost the weight, body is reading that I am into a catabolic state, I need to
23:02fight back.
23:03It's a survival instinct of a human being.
23:05This is how we survived.
23:07When we lost weight, body tries to come back so strongly.
23:12So what have all these diet, food companies and nutritionists doing then?
23:15Just cheating us?
23:16See, when you take, I am not saying that, you know, taking some less calories, I think
23:24what is required, you know, because often we eat more than the calories we require.
23:30We try to measure our calories, I wear this band just to measure my calorie uptake.
23:36But most of the time, by the time twelve o'clock, you realize you have already taken half your
23:40calorie for the day.
23:41And that's quite a lot.
23:43So when you do diet and exercise, everything is going against you because your hunger hormones
23:51are catching up.
23:52They are saying, please eat, please eat.
23:57Your metabolic rate is reducing.
23:59For the same exercise, for the same walk, you are actually spending less calories.
24:05Now these two things, when they happen, when you are taking less, then the moment you eat,
24:12it will just level it up.
24:14And it is the major nature of the human body.
24:18So is Ozempic a forever medicine then?
24:21I would say that it's a long-term medication like any of the metabolic disease.
24:27And as I reflected and I said that A, B, C, the attitude, behavior and choices.
24:32Of course, when you take the help of a medication and you come up, you reduce your body weight.
24:38And if you are one of those people that who have got the willpower to stay and you also
24:42get motivated because people also get motivated when they reduce the weight.
24:47I think then they can probably, you know, go to their doctors and find out the individual
24:55or you can say the flexible way of what is required.
24:58Because one of the issues is that if it's a forever medicine or a long-term medicine,
25:03then do we know enough about the side effects if you're taking it for such a long period of time?
25:09Some people have come up with blindness, pancreatic paralysis.
25:12These are very serious side effects, you know, not like vomiting and a little bit of diarrhea
25:18or dizziness or tummy aches.
25:20People are okay with that.
25:21But they're concerned about the most serious side effects, like how small a percentage
25:27is that and are you worried about the long-term effects?
25:30Has there been enough research around the long-term use of these medicines?
25:35Yeah, first of all, I think it's very important to see that how the medicine comes into the market.
25:44Medicine comes via the care for evaluation of phase 1, phase 2 and phase 3 data.
25:51Particularly, the semaglutide molecule has gone under extensive clinical research in phase 3
25:58and these authorities like USFDA, Europe, EMEA or Canada or Japan and also Indian authorities,
26:05they carefully evaluate the entire data for the benefit and the risk profile of the medicine.
26:13When the benefit outweighs the risk, that's the time medicine comes.
26:18Nonetheless, that data is already there and then we have got post-marketing data.
26:25With all these data, we actually submit something called as a safety update report to the authorities
26:32and when we submit the safety audit report, everything gets reported.
26:36While these incidents are there, they are not many in terms of the medicine for the benefit
26:44and the risk profile which is there.
26:46That is why medicine should be prescribed by a doctor because doctor can make the choice
26:53along with the patient choice whom it fits very well because otherwise,
26:59if the patient just go and take, they can do a mistake.
27:03One of the things that's also happening is people who don't necessarily need to use the medicine
27:08are using it, a lot of the celebrities.
27:11We had a small moment of body positivity where more normal sizing was acceptable
27:16and now again, you see on the red carpet that we are back to super skinny.
27:21Is this medicine going to put unrealistic pressures on society again?
27:27I think while I am worried about this unrealistic pressure, I am actually more worried about the
27:34pressure and the health of the nation in terms of the obesity
27:40because obesity is much more a larger problem than what we expect.
27:46Some of the people and I think the phenomena is that people who are thin want to further
27:51look thin.
27:53That may be in the fashion world, that is in the celebrity world and we always put a caution
27:58that please do not use it over the counter.
28:02Go to your doctor.
28:04It is indicated above 27 BMI if there is a disease or otherwise above 30 BMI.
28:11But the problem is actually the obesity but on the people who are taking it unnecessary,
28:19we always put a word of caution and I wish and hope that it can be stopped.
28:24So one of the things you said is the alarming rate of rise in obesity.
28:30We just had some of those numbers up on the screen and we will have 1 billion people who
28:36are obese by 2030 and 240 million people in India who are suffering from being overweight
28:42and obese.
28:43How do you see that medicine being available to a larger audience?
28:48Because currently it is roughly $1000 without insurance per month in America and about $30
28:56per month with insurance.
28:59Do you think that you will be able to provide this at a more reasonable number for India?
29:06The first issue which is coming across to us is that when we launched this medication,
29:14I think the demand was many, many fold than what we could actually produce.
29:21And you will not believe that 24 to 25 billion has been invested, billion dollars.
29:28That is almost the turnover of the pharma industry in India in terms of increasing
29:33the capacity of the production.
29:35When we invest that kind of an amount and when we invest in innovation, of course,
29:41the pricing is going to be benchmarked with the countries where it has been launched.
29:48But over the time when the usage increases, I am very sure that over a period of time
29:54and the important part is some of the people who can access can access this medication.
30:00Can I ask you one thing?
30:02If you treat a problem and a disease and delay the complication and hospitalization which
30:08is going to cost many fold, that is more important or treating obesity with this medication
30:17and preventing those complications and hospitalization, that is more important.
30:21So access, of course, when we launch is going to be a little bit of an issue because the
30:26pricing is going to be benchmarked with the world.
30:29But I wish and hope as the consumption increases over a period of time, the access becomes
30:34much more larger.
30:35Well, you are lucky here that we have a prime minister who is taking this very seriously
30:39and has actually appointed anti-obesity ambassadors who are looking at this problem that we are
30:47facing as a country and we will be dealing with it, I think, on a larger public level
30:53as well as in a personal level.
30:55Thank you so much for being with us.
30:58Our time is up but before you leave us, maybe you would like to give everyone one tip that
31:04they can follow for lunch today and that they can take it away with them before the medicine
31:10launches because Ozempic isn't actually available in India yet.
31:13Right, right.
31:15The only thing which I say is prevention is far more easier than curing it.
31:23So, act sensibly when you eat, what you actually do as an exercise and also when you need,
31:33please visit your doctor.
31:35Treating is far more easier nowadays than earlier.
31:39So, we are all going to be watching your lunch plate today.
31:42Thank you so much.