India’s Weight Loss Drug Craze Grows Amid Obesity Concerns

In Mumbai, diabetologist Rahul Baxi has been receiving an influx of requests, but not solely from patients battling blood sugar issues anymore.

More frequently, younger professionals are coming in with a similar plea: “Doctor, can you prescribe me weight-loss medications?”

A recent visit involved a 23-year-old man, anxious about the 10 kg he’s added since starting a high-pressure job. “One of my gym buddies is using those injections,” he mentioned.

Dr. Baxi declined his request, prompting the young man to consider his plan post-weight loss. “You stop, the weight just returns. Keep using them without exercise, and you might lose muscle instead. These meds can’t replace a healthy diet or lifestyle changes,” he advised.

This type of discussion is becoming more common, as the popularity of weight-loss drugs surges in urban India, a nation with the second-highest number of overweight adults globally and over 77 million who suffer from Type 2 diabetes.

Initially created for diabetes treatment, some of these medications are now seen as revolutionary for weight loss, delivering results that many past treatments could not. However, their rising usage brings up complex issues regarding the necessity of medical guidance, the potential for misuse, and the fine line between treatment and lifestyle enhancement.

“These are the most effective weight-loss drugs seen to date. Numerous medications have been introduced and faded away, but these stand out,” remarks Anoop Misra, who directs the Fortis-C-DOC Centre for Diabetes and Endocrinology in Delhi.

The Indian weight-loss market is currently dominated by two drugs. One is semaglutide, available as Rybelsus (oral) and Wegovy (injectable) from Danish firm Novo Nordisk, while Ozempic (another injectable) is approved for diabetes but not yet available for obesity. The second is tirzepatide, produced by Eli Lilly and sold as Mounjaro, which was primarily developed for diabetes but is increasingly being used for weight loss.

These belong to the GLP-1 drug class, which imitates a hormone that regulates appetite. They work by slowing down digestion and influencing the brain’s hunger signals, helping users feel full quicker and for longer periods. Typically injected weekly, these drugs are administered in the arm, thigh, or abdomen. In Mounjaro’s case, they can also enhance metabolism and energy levels.

Patients generally begin treatment at a low dose that gradually increases. Most start losing weight within a few weeks. Still, experts caution that many regain lost weight within a year of halting the injections since the body often resists continued weight loss and old cravings return. Extended use without physical activity can lead to muscle loss alongside fat reduction.

Furthermore, not everyone responds to GLP-1 medications—a typical plateau occurs after losing about 15% of body weight. Side effects can include nausea and diarrhea, and there are more severe risks like gallstones, pancreatitis, and muscle loss. Given India’s predominantly high-carb, low-protein diet, weight loss without proper dietary balance can exacerbate sarcopenic obesity, where muscle loss accompanies fat gain.

“With all the media coverage, there’s become something of a frenzy among wealthy Indians aiming to drop a few pounds,” Dr. Baxi notes.

A physician based in Delhi shared that this urgency was palpable even during a recent medical conference. “After just three months following the launch of a new drug, I’d seen about a hundred patients, while a colleague had treated over a thousand—most of them used imported medications bought illegally.”

India’s anti-obesity drug market has ballooned from $16 million in 2021 to nearly $100 million today—over six times its size in just five years, according to Pharmarack, a research firm.

Recognized as a market leader, Novo Nordisk’s semaglutide products have claimed around two-thirds of the market since Rybelsus launched in 2022. Eli Lilly’s tirzepatide, introduced early this year, had already become the second-best-selling branded medication in India by September, according to Pharmarack. Monthly costs for these injectable pens, typically containing four doses, range from 14,000 to 27,000 rupees ($157–300), which is a significant expense for many.

Looking ahead, India may be on the brink of a major shift. By March, the patent for semaglutide will expire, potentially leading to lower-cost generic options and wider accessibility. Jefferies, an investment bank, describes this as a “magic pill moment,” forecasting that the market for semaglutide could hit $1 billion if pricing, adoption rates, and government incentives align effectively.

Sheetal Sapale, a vice-president at Pharmarack, mentions that approximately a dozen firms are reportedly preparing to launch generic versions of Rybelsus. However, as affordability rises, so does the risk for misuse.

There are already instances of patients being put on high-dose weight-loss drugs by unqualified gym trainers, nutritionists, and beauty clinics. Some online pharmacies dispense these medications following superficial phone consultations, bypassing prescriptions altogether. Beauticians often package rapid weight loss as “bridal packages” ahead of wedding events, raising fears of counterfeit drugs flooding the market. Federal minister Jitendra Singh has issued warnings regarding the new medications.

“A patient once asked me if these new drugs could help his daughter shed seven kilos before her wedding—within three months,” recalls Dr. Bhaumik Kamdar, a chest physician in Mumbai. “He just wanted to know if they actually work.”

Another layer of complexity in India is how obesity is perceived socially and its impact on attitudes regarding weight loss.

“Many don’t realize that obesity is a chronic condition,” says Dr. Muffazal Lakhdawala, a bariatric surgeon based in Mumbai. “People battling chronic obesity often resort to quick-fix diets: they drop some weight, only to regain it later.” He adds, “In India, being overweight is often seen as a sign of prosperity. We’ve become so adept at ignoring the issue that we’ve normalized it.”

Medical professionals stress that obesity opens the door to a multitude of health problems, linking it to at least 20 different cancers, infertility, osteoarthritis, and fatty liver disease, which can lead to cirrhosis. Despite its global impact on nearly one-eighth of the population, there’s still no universally recognized definition or classification system for obesity.

“The emergence of these drugs has shifted the dialogue—obesity is now being recognized as a medical condition rather than just a lifestyle choice.”

Doctors across multiple fields are increasingly considering weight-loss medications for purposes beyond just treating obesity or diabetes.

Endocrinologists, diabetologists, cardiologists, and nephrologists are prescribing these to overweight patients to enhance heart and kidney health—particularly for those awaiting procedures like angioplasty or stenting. Orthopedic surgeons recommend these drugs to individuals needing to lose weight prior to knee surgeries, and chest specialists use them for patients suffering from sleep apnea, where weight reduction can improve sleep quality without the need for CPAP machines.

Bariatric surgery is also adapting to India’s obesity epidemic, having surged from merely 200 procedures in 2004 to around 40,000 in 2022—a sizable increase.

Surgeons like Dr. Lakhdawala now run multidisciplinary programs, guiding patients on weight-loss treatments under the supervision of endocrinologists, nutritionists, and psychologists for periods of three to six months. “We aren’t handing out drugs casually,” he insists. “Those unresponsive to medication or with severe obesity may then consider surgical options.”

His straightforward message to urban Indians seeking easy solutions is, “Don’t use the medications for cosmetic weight loss; utilize them to combat dangerous weight gain.”

And for those simply wanting to shed five or ten kilograms?

His advice is refreshingly simple: “Eliminate sugar—it’s the main culprit. Without this step, weight loss won’t be sustainable. Incorporate four days of exercise per week, and you’ll lose that 5-7 kg—no injections required.”