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The Taste with Vir: Will weight-loss drugs finish off the diet business?


Do you still talk about diets? Read diet books? Watch diet videos? Go to celebrity dieticians? Look for low-fat products at the grocery shop or when you are ordering online?

The new drugs make the pleasure centres feel satiated much earlier than before; say, halfway through the sort of meal you would have completed in the old days. You begin to feel full and stop eating.(Gustavo Fring)

I am guessing you do all this much less than you used to.

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Over the last few decades, such diets as Fit For Life, Dr Atkins, the F Plan etc. had become rages and the subjects of innumerable conversations. Many books based on hyped diets were bestsellers. But now, for reasons I can’t fully explain, the branded diets are less popular and diet books sell much less.(Also read | The Taste by Vir Sanghvi: Discover the top pizza chefs and restaurants in Naples making waves globally)

That’s our experience in India. It’s much worse in the West where the diet industry is staring at imminent collapse. The books don’t sell any longer, the diet clinics are emptying out, the videos are unwatched and diets no longer dominate conversation in the way they once used to.

In the West, there is a simple explanation for the death of the diet cult: modern medicine. Two new drugs– Semaglutide and Tirzepatide–have the potential to finish off the diet business. They have already done immense harm to the economic prospects of those companies that made their profits from promising to make us thin. And it will get worse for the diet business.

I have written before, at length, about the new drugs so I won’t repeat myself. But here’s what you need to know. Both drugs are prescribed as once-a-week injections that you can administer yourself (like an Epi Pen). They work by affecting the brain’s pleasure centres. Normally, when you have eaten enough, those centres are satiated and you feel you don’t need to eat more. The new drugs make the pleasure centres feel satiated much earlier than before; say, halfway through the sort of meal you would have completed in the old days. You begin to feel full and stop eating.

The drugs don’t fully kill your appetite: You will still feel hungry and want to eat. (Though you will eat much less than you used to.) They don’t turn you against food: You will still enjoy the dishes you have always liked. They just make you want to end your meals earlier.

For years, the modern diet industry has worked to discredit the old calorie counting idea which stated that if you consumed less calories, you would lose weight. The central message of most diet gurus has been: It is not how much you eat, it is what you eat and when you eat it that matters.

So, we have had food-combining diets (no fruit with meals), high protein diets (cut out carbs) vegan diets and fasts. The central principle of intermittent fasting, for instance, is that you can eat as much as you like if you do it in an eight-hour time frame.

These diets may or may not work. But the message coming from modern medicine is: Forget all that stuff about tricking your body into losing weight. You don’t have to refuse food after 7 pm and or stop putting ghee on your roti. You don’t have to identify food groups (proteins, carbohydrates) before deciding what you can eat for dinner. Just eat less (which the new drugs will make you) and you will lose weight.

To the horror of the diet gurus it has worked. People are losing more weight on these medicines than they ever did consistently on the fad diets. And they don’t have to buy low fat products, give up bread or eat alfalfa sprouts. They eat what they like, when they like, confident that their brains will tell them when to stop.

In the circumstances, who would want to go on a fad diet? Who would starve themselves, pausing only to eat three almonds every four hours or so? Who would want to have to fight hunger if it came outside of an eight-hour window?

The axiom that our grandparents taught us was: “Eat everything but in moderation.” This is a message the fad dieticians dismissed when they told us we could not eat everything. Now modern medicine is telling us that it was the right message all along. And it is giving us the medication required to stick to the philosophy of our ancestors.

The usual response to the eat-everything-in-moderation prescription has been that people with medical conditions can’t really eat everything. For instance, diabetics must restrict their diets. So, should people with kidney conditions.

That’s fair enough, but sadly for the dieticians, the new drugs also work against diabetes (they control sugars) and new evidence suggests that Semaglutide helps with kidney conditions.

All of this is, so far at least, mostly academic for us in India because the new drugs are not easily available in our country. But, by next year, that is certain to change. There is already talk of manufacturing them in India and given how prevalent Type-II diabetes is in India, there is a solid medical case for prescribing them. (The weight loss is a happy side-effect for diabetics.)

Once that happens, it spells trouble for the manufacturers of so-called low-fat or diet foods. And the celebrity dietician is about to become a dinosaur, on the verge of extinction.

What will happen next? Well, there will always be some people who will refuse to take the drugs. They do have side-effects: Like nausea, abdominal distress and (in a small number of cases) a rise in anxiety. In the West, some early adopters have gone off the drugs because they can’t handle the side-effects. The drugs are also expensive. But it is fair to say that if you can afford to go to a celebrity dietician then you can probably afford Semaglutide too.

In the West, market penetration is just starting to reach the heartland (there is a shortage of these drugs because demand far outstrips supply) but urban elites (models, movie, stars, Oprah Winfrey and the like) take them regularly with dramatic results.

In India, I find it hard to believe that they will penetrate the mainstream because of pricing, but they will appeal to educated city-dwellers (i.e. the sort of people who read diet books).

Once they catch on, they will transform the weight-loss landscape. This is good news for many people; not just those who are taking the injections and losing weight but also others like the manufacturers of foods regarded as too fatty. But it’s bad news for chefs who do 12-course tasting menus. By course four of the meal, people on the medication will be ready to go home. It’s bad news too for the makers of those bogus diet products which people will realise they no longer need.

What’s not clear is how they will affect the exercise industry. All doctors, including those who prescribe Semaglutide, will tell you that exercise is essential even if you don’t need to lose weight. But if you are going on an exercise regime only to lose weight, there are now better ways.

There are more weight-loss drugs on the way. The makers of Ozempic, the best-known brand of Semaglutide, may be able to improve the formulation to lessen the side-effects. And the makers of Mounjaro, the brand name for Tirzepatide, are testing a new oral drug which may be more effective than the injection.

So, you are the sort of person who worries about losing weight, relax. Help is finally on its way.



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