India is experiencing a rapid surge in demand for weight-loss drugs, particularly GLP-1 medications like Rybelsus and Mounjaro, driven by urban professionals and those with obesity, but this boom raises serious concerns about misuse, side effects, and the proliferation of unregulated products. As more Indians seek quick fixes for weight management, medical experts warn that these powerful drugs require strict supervision and are not substitutes for lifestyle changes, highlighting the blurred line between treatment and cosmetic enhancement.
The calls come thick and fast to diabetologists like Mumbai-based Dr. Rahul Baxi, who notes an influx of young professionals asking for weight-loss jabs, often inspired by gym friends or social media trends. Recently, a 23-year-old man sought help to lose 10kg gained from a corporate job, but Dr. Baxi refused, emphasizing that stopping the drugs could lead to weight regain and that without exercise, users risk losing muscle instead of fat. Such conversations are becoming commonplace in urban India, a country with the world’s second-largest number of overweight adults and over 77 million people with Type 2 diabetes, fueling a frenzy for these medications.
Originally developed for diabetes, GLP-1 drugs like semaglutide (sold as Rybelsus and Wegovy) and tirzepatide (marketed as Mounjaro) mimic natural hormones that regulate hunger, slowing digestion and acting on appetite centers in the brain. Taken once a week via self-injection, they help users feel full faster and stay full longer, with weight loss typically beginning within weeks. However, doctors caution that most people plateau after losing about 15% of body weight and can regain weight within a year of stopping, as the body resists weight loss and old cravings return.
India’s anti-obesity drug market has exploded from $16 million in 2021 to nearly $100 million today—a more than sixfold jump in five years—with Novo Nordisk leading the market and Eli Lilly’s Mounjaro quickly rising to become the second-bestselling branded drug. Each monthly injectable pen costs between 14,000–27,000 rupees ($157–300), making it steep for most Indians, but the pending patent expiration for semaglutide in March could unleash cheaper generics, potentially expanding access but also increasing risks of misuse.
The growing popularity has led to alarming practices, such as gym trainers, dieticians, and beauty clinics prescribing these drugs without authority, and online pharmacies delivering them after cursory consultations. Beauticians offer ‘bridal packages’ promising rapid slimming, while fears of spurious medicines flood the market. Federal minister Jitendra Singh has advised caution, and doctors share stories of patients being put on high dosages improperly, underscoring the need for regulated use.
Medical professionals stress that obesity is a chronic, relapsing disease linked to over 20 cancers, infertility, osteoarthritis, and fatty liver disease, yet it is often perceived as a lifestyle issue in India. Dr. Muffazal Lakhdawala, a bariatric surgeon, notes that society has normalized overweight conditions, but the arrival of these drugs is shifting the conversation to treat obesity as a disease. Doctors across specialities, including cardiologists, nephrologists, and orthopaedic surgeons, are now prescribing weight-loss drugs to improve outcomes for conditions like heart disease, kidney issues, and pre-surgical weight loss, integrating them into multidisciplinary care programs.
Looking ahead, the potential for generic versions could make these drugs more accessible, with Jefferies investment bank predicting a ‘magic pill moment’ that could grow the semaglutide market to $1 billion with right pricing and incentives. However, this accessibility heightens the risk of misuse, and doctors urge that these drugs should be used for life-threatening weight gain, not cosmetic purposes. For those seeking to lose minor weight, simple advice like cutting sugar and exercising regularly remains the safest path forward.
In conclusion, while India’s weight-loss drug boom offers hope for addressing obesity and related health issues, it demands careful management to mitigate risks. The emphasis must remain on medical supervision, patient education, and holistic lifestyle changes to ensure that the benefits outweigh the dangers in this rapidly evolving landscape.