Ozempic and Wegovy have received a lot of publicity as revolutionizing treatment options for obesity. Both medications form a class of GLP-1 receptor agonists, which mimic a hormone in the body called glucagon-like peptide-1 and are involved in the regulation of appetite and blood sugar. Indeed, in initial clinical studies, the majority of those on the drugs lost 15% to 22% of body weight, hence much optimism. For most patients, these medications are underwhelming for about 20% of patients due to minimal weight loss or other challenges.

Take a closer look at why the weight loss drugs may not work for everyone, together with what options exist when they don't deliver the expected outcomes.

Why Weight Loss Drugs May Not Work

While GLP-1 receptor agonists have produced phenomenal responses in a majority of patients, it remains a reality that these drugs work differently for different people. Here's why:

1. Genetic and Hormonal Variability

Weight loss medications interact with complex systems in the body that differ from person to person. Genetics, hormones, and individual brain responses to energy regulation play significant roles in determining how a person responds to drugs like Ozempic and Wegovy.

2. Underlying Medical Conditions

Other conditions, such as sleep apnea, may be prevalent and prevent or delay the achievement of weight loss goals. Prescription drugs like antidepressants, steroids, or contraceptives are other medications that can nullify weight loss medication benefits.

3. Unrealistic Expectations

Often, they come to these medications with enormous hopes; expecting the promised rapid and dramatic weight loss. Progress creates disappointment if it has not stalled. In patients who rigidly follow recommended lifestyle modifications, frustration and disappointment are most common.

Why it is Important to Identify Non-responders

For most patients, the effectiveness of GLP-1 receptor agonists is evident within a few weeks of treatment. Weight loss typically begins within a few weeks of initiating therapy and tends to increase with dosage. However, some patients respond very little, if at all, despite strict adherence to their regimen.

For nonresponders, this can feel like a dead end. However, understanding the unique complexities of obesity is essential. This condition stems from brain dysfunction, and the pathways that contribute to weight regulation differ among individuals.

Alternative Treatment Options

When Ozempic or Wegovy doesn’t yield desired results, there are still many paths to explore:

1. Switching to Another GLP-1 Drug

For example, some patients who don't respond well to one GLP-1 receptor agonist might find success with another drug in the same class. Newer medications, such as Zepbound, target other hormone pathways and seem promising even for those not responsive to earlier drugs.

2. Use of Older Medications

While there is much to say about newer drugs, older treatments can still be useful and work for some patients. One can also seek the help of a medical provider specializing in obesity treatments in order to identify the best alternatives.

3. Lifestyle Changes

Diet, exercise, sleep, and stress management continue to be integral components of any weight loss program. New changes may be small but can make an enormous difference in one's health and success.

4. Medical Management of Obesity

It is a complex disorder, and most patients should receive a multidisciplinary treatment. Collaboration with an obesity-aware doctor may mean access to tailored treatment plans, ranging from psychological support all the way to metabolic testing, and many others.

Why Side Effects of Weight Loss Drug Ozempic May Be a Barrier

For others, side effects like nausea, vomiting, or diarrhea hinder them from continuing with these drugs. These symptoms often reduce as the body becomes accustomed, but for some, they might be severe enough to stop treatment altogether. In those instances, alternative drugs or procedures become vital to find.

Long-term effects of Ozempic or Wegovy on the Brain

Another largely unexplored area relates to GLP-1 drugs' long-term effects on the brain's regulation of hunger and satiety. Although GLP-1 drugs suppress appetite and can lead to effective weight loss, emerging research suggests that they may also affect brain reward mechanisms, changing the way patients experience foods.

This aspect could prove of paramount significance in the future treatment of obesity. Perhaps GLP-1 receptor agonists do indeed affect and rewire the brain's reward pathways and will thus provide sustained benefits beyond discontinuation. However, more research is required to understand this phenomenon fully.

While for many, Ozempic and Wegovy have revolutionized obesity treatment, these are certainly not a one size fits all. Nonresponders need not lose hope- alternative strategies and medications abound. A consultation with an obesity expert healthcare provider is essential to put together a comprehensive, tailored treatment plan.

The route toward effective weight loss may be challenging, but with the evolution of obesity medicine and a better understanding of individual needs, there is a path forward for everyone.

One in four or 25 percent of adults with type-2 diabetes in India also suffer from liver fibrosis, according to an alarming study published in The Lancet Regional Health Southeast Asia journal today.

With data from more than 9,000 patients across the country, it is the largest ever real-world survey of liver fibrosis in type 2 diabetes from any low- or middle-income country.

While fatty liver disease has been touted as the most common liver condition among diabetes patients, the new study established liver fibrosis as the real danger among people with high blood sugar.

“Type 2 diabetes is closely linked to fatty liver disease (also known as MASLD). But how common is liver Fibrosis — the real danger — in Indian diabetics? Our answer: 1 in 4 has clinically significant liver fibrosis. One in 20 already has probable cirrhosis. Most had no symptoms. We propose liver fibrosis as the ‘4th major complication’ of diabetes,” said Ashish Kumar, from Ganga Ram Postgraduate Institute of Medical Education and Research (GRIPMER), from Sir Ganga Ram Hospital, in a post on social media platform X.

Also read: About 84% IT Employees Are Suffering With Fatty Liver Disease - Why Screenings Are Necessary For Corporate Workers

What Did The Study Find?

Fatty liver is typically the first and reversible stage of liver disease, where excess fat builds up in liver cells. Left untreated, it progresses to liver fibrosis, which is the excessive accumulation of scar tissue (collagen) in the liver resulting from chronic inflammation. The condition then progresses to the third and late stage, irreversible scarring (fibrosis) of the liver. The final stage is liver cancer.

The DiaFib-Liver Study included a total of 9,202 adults with type-2 diabetes patients who underwent FibroScan (VCTE) to assess liver fibrosis in routine diabetes care.

Of these:

• 26 percent had clinically significant fibrosis,
• 14 percent had advanced fibrosis,
• 5 percent had probable cirrhosis
• 65 percent had fatty liver disease.

• obesity
• dyslipidaemia
• kidney problems
• diabetes duration ≥10 years.

Fibrosis: The Screening Target

The study suggested the urgent need to integrate fibrosis screening into national diabetes programs.

“One in four adults with type 2 diabetes in India has clinically significant liver fibrosis and one in twenty already has probable cirrhosis, establishing advanced liver disease as a 'fourth major complication' of diabetes,” said the researchers.

“The DiaFibLiver Study calls for: Fibrosis — not steatosis — as the screening target. FibroScan integration into routine diabetes care. Moving beyond ultrasound-based referral,” Jha said.

“We hope this data from India adds to the global conversation on diabetes and liver disease,” he added.

Also read: The Silent Rise of Fatty Liver Disease: How India-Specific Guidelines Can Help

The findings highlight the urgent need to:

• move beyond steatosis
• systematically integrate fibrosis assessment into routine diabetes care,
• deploy non-invasive tools such as vibration-controlled transient elastography (VCTE) in community practice
• define screening strategies,
• evaluate therapeutic interventions.

Everyday Habits That Harm the Liver

Certain lifestyle choices can accelerate liver damage, such as:

Overeating processed or fried foods

High sugar intake (soft drinks, sweets, desserts)

Physical inactivity or prolonged sitting

Ignoring health issues like diabetes or hypertension

Crash dieting or taking unprescribed supplements.

How To Improve Liver Health?

Early screening and detection are key to prevent irreversible stages. Yet liver disease can be prevented with lifestyle changes such as:

• Eating a balanced diet with vegetables, fruits, whole grains, and lean protein
• Engaging in at least 30 minutes of exercise daily
• Staying hydrated to help the liver flush out toxins
• Avoiding alcohol and smoking
• Avoiding self-medication and unnecessary pills
• Getting routine health screenings.

New Delhi: Every day, the brain processes hundreds of choices. Most pass unnoticed: what to wear, which route to take, what to eat. But accumulated over hours and across competing demands, this constant decision-making exacts a cost. Decision fatigue is the gradual erosion of the brain’s capacity to make good choices, and over time it affects both mental functioning and physical health. Dr Shivi Kataria, Consultant – Psychiatry, CK Birla Hospitals, Jaipur, addressed the problem of plenty and said that it could take a toll on mental health in certain circumstances.

Read more: India Launches 1st Repository Of Data On Major Psychiatric Disorders

What are the signs?

The earliest signs tend to be emotional. Simple decisions start to feel disproportionately heavy. Choosing between two options takes longer than it should. Irritability surfaces. Tasks that once felt manageable begin to pile up as the mental energy required to engage with them thins. Procrastination, self-doubt, and a general withdrawal from decisions are common responses, with the brain essentially rationing what little capacity remains.

Cognitive symptoms follow. Concentration narrows. Judgement becomes less reliable. Small errors accumulate. People in this state often describe feeling mentally stuck, present in the room but unable to engage with any clarity or momentum.

The physical dimension is frequently overlooked. Headaches, low energy, disrupted sleep, and difficulty sustaining attention are all associated with sustained decision overload. These symptoms register what prolonged mental strain produces in the body and are worth taking seriously.

Who is most at risk?

Decision fatigue affects most people at some point, but the load is not evenly distributed. Professionals in high-responsibility roles, caregivers, and anyone managing multiple competing demands make a disproportionately high number of decisions each day. By the end of a long day, the quality of choices made about food, purchases, relationships, or work often reflects exhaustion more than intention.

Read more: Smartphone Overuse Linked To Rising Risk Of Eating Disorders Among Youth, Study Finds

Is there a solution?

Reducing the number of decisions that require active thought each day is the most direct intervention. Fixed routines for meals, schedules, and recurring tasks remove the need to deliberate repeatedly over the same ground. This is conservation of mental energy, and it compounds over time.

Important decisions are better made earlier in the day, when the brain is rested and cognitive resources are intact. Short breaks during sustained work periods allow partial recovery. Even brief physical activity or deliberate rest between decision-heavy tasks restores some capacity.

The brain has a finite decision-making budget each day. Spending it on low-stakes choices leaves less available for the ones that carry real consequence.

While fevers are often overlooked and brushed aside or even managed with antibiotics — a dangerous trend — an alarmingly nationwide study linked it to infectious diseases with far-reaching consequences.

The report, based on data of over one lakh individuals in India with fever, between 2023 and 2025, showed that these were not vague or self-limiting, but in more than 30 percent or one-third cases had clear links to serious infections, such as dengue, and typhoid.

According to the report by healthcare diagnostics company Thyrocare, the fevers were mostly linked with

• typhoid – in over 18 percent cases
• dengue -- over 14 percent cases.
• Other diseases include malaria, chikungunya, and leptospirosis.

Presence Of Multiple Infections

Importantly, the findings highlighted the presence of co-infections in 10 per cent cases. The most common was a combination of dengue and typhoid.

Dr Preet Kaur, Chief Scientific Officer, Thyrocare, said that a significant number of patients carry serious infections, sometimes more than one at a time, revealing patterns that simple assumptions cannot capture.

"Beyond the visible rise in temperature, laboratory markers highlight hidden stress on organs, from drops in platelet counts to elevated liver enzymes, underscoring that fever is a systemic signal, not an isolated event," she added.

Also read: ‘Breakbone Fever’: US CDC Warns Of Dengue Surge Across 17 Countries

Further, the report noted that dengue positivity declined significantly over the three-year report period, malaria increased despite its lower overall base.

Typhoid and chikungunya rose in 2024 before easing in 2025 but remained present across the testing population.

Also read: Drug Resistance Driving Severe Typhoid Disease, Death Among Children Under-5s in India: Lancet Study

Fever: Men Vs Women

The report noted that more women were affected with typhoid than men. On the contrary, men reported more malaria cases.

More than 32 percent of females had fevers compared to 29 percent of men. Fevers in women was largely driven by higher typhoid detection (21 percent vs 15 percent).

Malaria affected men more than twice as often as women (1.1 percent vs 0.5 percent).

The lab reports also revealed key physiological markers such as platelet counts and liver function among people with fever, dengue, and malaria.

Low platelet levels were seen in

• 27 percent of patients with fever
• 80 percent malaria positive patients
• 37 percent dengue-positive patients

• All fever patients (56 percent) showed elevated SGOT levels and 37 percent SGPT
• Liver stress was seen across patients with dengue, malaria and leptospirosis.

Dengue cases rose throughout the year and typically peaked around October.

Typhoid positivity steadily fell from 2023 to its lowest in 2025. Despite a mild monsoon spike each year, 2025 remained consistently lower overall.

Chikungunya cases rose gradually from lower, volatile levels in 2023, peaked sharply in 2024, and moderated to a softer trend in 2025.

Malaria positivity remained relatively low overall but increased during the monsoon months, with transmission peaking between May and September.

Over the three-year period, malaria positivity rose from 0.5 percent to 1.1 percent, indicating a gradual increase despite its lower overall base.