The WEEK Metabolic Health Summit: Tackling the rising tide of obesity and diabetes

KERALA’S REMARKABLE GAINS in life expectancy, maternal and child health, and overall health indicators have long been celebrated as a public health success story. Yet, in a striking irony, the state is a hotspot for diabetes, obesity and other metabolic disorders. That paradox was at the heart of THE WEEK Metabolic Health Summit in Thiruvananthapuram on October 6.

Inaugurating the summit, Health Minister K. Muraleedharan said Kerala was facing a rising wave of non-communicable diseases, particularly diabetes, hypertension and cardiovascular conditions, creating a growing cardiometabolic burden. “Conditions like diabesity—the dangerous intersection of diabetes and obesity—are no longer distant threats; they are actively shaping the health outcomes of our families and communities,” he said.

He said Kerala needed to shift from late-stage treatment to early detection and management. “Early screening at the primary care is essential to bend the cardiometabolic curve before complications arise,” he said.

Dr Sharmila Mary Joseph, principal secretary (health), said strengthening health care infrastructure and human resources was crucial for sustaining Kerala’s health gains. The government machinery, she said, was focusing on transforming primary health care, upgrading secondary and tertiary facilities, expanding digital health care and ensuring affordable public health care. “Availability, accessibility and affordability are the bedrock of our health care system,” she said.

She added that Kerala was using children and health care workers as “ambassadors of change” to promote healthier habits, while routine NCD screening at primary and secondary health facilities is being strengthened for early detection and treatment.

Dr Renu Raj, state mission director, National Health Mission, said Kerala needed to connect its existing systems better, from screening and follow-up to primary and specialist care, hospitals and communities. She also called for stronger collaboration among the government, doctors, academia, industry, media and citizens. “No single drug, wonder app, hospital or department can solve this problem,” she said. “It requires an alignment of policy, medicine, markets, research, communities and individual behaviour.”

Dr V. Meenakshy, director of health services, elaborated on the various programmes being undertaken on prevention-oriented health system in her keynote address.

Dr K.V. Viswanathan, director of medical education, emphasised that prevention must begin early because the biological damage associated with metabolic disorders starts well before disease becomes clinically apparent. Kerala, he said, was well placed to lead this effort because of its strong public health platform, educated population and established medical institutions.

Dr P.K. Jabbar, joint director, Directorate of Medical Education, highlighted the growing economic burden of metabolic disorders, warning that the rising prevalence of obesity and diabetes could translate into a significant crisis for Kerala through direct costs and indirect costs such as lost productivity. He said that metabolic disorders had far-reaching health consequences, with obesity and diabetes closely associated with hypertension, coronary disease, fatty liver disease (MASLD/MASH) and several types of cancer.

Dr Jabbar said the rapidly growing burden of obesity and related metabolic diseases made it essential to “bend the curve” through early and sustained interventions rather than simply responding to rising numbers. He noted that GLP-1 receptor agonists, which mimic the action of the natural hormone GLP-1, had emerged as an important tool in this changing paradigm, with growing use and strong long-term evidence for weight reduction and broader metabolic benefits. However, he stressed that pharmacological treatment must complement, rather than replace, lifestyle and other non-pharmacological interventions.

Dr Jothydev Kesavadev, chairman and managing director of Jothydev’s Diabetes Research Centre, said obesity should now be regarded as a medically treatable disease. “Never delay the treatment,” he said, calling for integrated cardiometabolic care and early intervention with GLP-1 receptor agonists such as semaglutide.

Novo Nordisk, a major player in the GLP-1 market, meanwhile highlighted the challenges of translating advances in obesity science into wider clinical practice in India. Vikrant Shrotriya, managing director of Novo Nordisk India, said a key challenge was ensuring that advances in obesity treatment translated into broader access and adoption across the health care system. “The principal challenge that we face is that a lot of times the billions of dollars of science gets discredited. A lot of times, we are actually part of the industry, but we are not part of health,” he said.

Shrotriya said newer treatments often remained concentrated in tertiary-care settings, limiting access to patients who could benefit from earlier intervention. He added that the broader challenge was the recognition of obesity as a medical condition in India. “Obesity is still far away from medicalisation in India,” he said, arguing that newer therapies needed to reach primary and secondary care before patients reached more advanced stages of disease.