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The current state of obesity in India is alarming. As was evident from Prime Minister Narendra Modi’s 119th Maan Ki Baat, where he cautioned against the rise in obesity cases that have doubled in the last few years. A major concern during his speech was how children are getting affected more. Union Minister Dr Jitendra Singh, a renowned Diabetologist, also raised alarms while underscoring the urgent need for a multifaceted and collective approach to combat the growing obesity crisis in India.
India’s stint with obesity started in the last 20th century with people getting addicted to sugary drinks, junk foods etc. Rapid urbanisation, economic development, lifestyle changes and less physical activity all contributed to a rise in the obese population.
Obesity is linked with stigma, and many encounter fat shaming. It leads to psychological stress. This apart, an obese person is vulnerable to various health issues like heart disease, type 2 diabetes, high blood pressure, cancer, sleep apnea, etc.
Launch of anti-obesity drugs
Seeing this as a strategy to market anti-obesity drugs, many multinational pharmaceutical companies are in a rat race to launch various products. With the launch of weight-loss drugs in the Indian market, the debate around pharmacological obesity treatment has intensified.
Seeking an opportunity, the US pharma major, Eli Lilly, recently launched Mounjaro. It is a single-dose vial presentation and has received marketing authorisation from the Central Drugs Standard Control Organisation (CDSCO). The company went ahead and also launched a campaign to combat the associated stigma with obesity.
Winselow Tucker, President and General Manager, Lilly India, claims, “Our mission to make life better for people living with obesity and diabetes in India is reflected in our efforts to accelerate the introduction of innovative medicines. The launch of Mounjaro demonstrates our ongoing support of this mission and our shared vision of a healthier nation.”
Danish pharma major Novo Nordisk plans to launch its anti-diabetes and weight loss drug Wegovy in India. According to Martin Holst Lange, Executive VP for Development at Novo Nordisk, the company is dedicated to providing improved treatment options for people living with obesity, Type 2 diabetes, and other cardiometabolic diseases. The addition of a candidate targeting glucagon, as well as GLP-1 and GIP, will add important optionality to our clinical pipeline as we look to develop a broad portfolio of differentiated treatment options that cater to the diverse needs of people living with these highly prevalent diseases.
Many more companies may join the bandwagon to capture the obesity market in India. But at what cost?
Miracle drug or risky gamble?
Despite being claimed to give quick relief, weight-loss drugs are known to have side effects, according to experts and doctors working in this field.
Prof (Dr) Subhrojyoti Bhowmick, Vice President (Projects and Academic Initiatives), Department of Pharmacology, KPC Medical College and Hospital, Jadavpur, says, “Despite its effectiveness, Mounjaro is not without risks. Common side effects include nausea, vomiting, diarrhoea, and gastrointestinal discomfort. More severe complications, such as pancreatitis, gallbladder issues, and potential cardiovascular risks, have also been reported. A major concern is the potential for misuse. With the increasing demand for quick-fix weight loss solutions, there is a risk that people without medical indications may start using the drug indiscriminately. This could lead to serious health repercussions, especially if taken without professional supervision.”
Research indicates that two-thirds of users discontinue these drugs within a year due to gastrointestinal issues such as nausea, vomiting, diarrhoea, and constipation, as well as more serious complications like pancreatitis or gallbladder problems. After discontinuation, most users rapidly regain the weight they initially lost because these drugs do not address the underlying metabolic causes of obesity, such as insulin resistance, inflammation, and dietary habits.
While explaining the limitations of GLP-1 drugs and why a dietary approach offers a more sustainable solution for weight management, Dr Vanita Rahman, an internal medicine physician and weight-loss expert, Physicians Committee for Responsible Medicine (PCRM) says, “Given India’s growing obesity epidemic and high prevalence of metabolic disorders, it is essential to balance the excitement around these therapies with caution. As data on cardiovascular safety and long-term mortality risks continue to emerge, sustainable weight management must prioritise dietary and behavioural modifications over pharmacotherapy alone.”
It is difficult to prescribe these medicines for a longer period. This is according to Dr Aparna Govil Bhasker, Consultant Bariatric and Laparoscopic Surgeon, MetaHeal - Laparoscopy and Bariatric Surgery Center, Mumbai; Saifee, Apollo, and Namaha Hospitals, Mumbai. Dr Aparna opines, "Mounjaro and the other drugs in the same category have shown good results in the trials that have been conducted and have shown about 15 to 20 per cent total body weight loss while the individual is on medications. The main concerns are the possibility of rebound weight gain after stopping medications. Studies have shown that a significant number of patients regain weight after the drugs are withdrawn. There is presently no long-term data available regarding the weight loss outcomes or the side effect profile.”
Need for proper guidelines
Currently, no medications for obesity are included in the Essential Medicines List (EML). However, given their dual role in treating both type 2 diabetes and obesity, GLP-1 receptor agonists such as semaglutide and tirzepatide could be considered for inclusion.
Leena Menghaney, Lawyer/Consultant, Public Health, Pharmaceuticals & Access opines, “In middle-income countries like India, these medications are not being rationally prescribed due to the absence of guidelines from regulatory bodies such as the Indian Council of Medical Research (ICMR) and the lack of guidance from the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) on the use of GLP-1 receptor agonists in the management of type 2 diabetes and obesity.”
Dr Rajiv Kovil, Head of Diabetology, Zandra Healthcare and Co-founder of Rang De Neela Initiative says, "Obesity is a complex disorder requiring medical intervention, including pharmacotherapy. Drugs like Mounjaro should be prescribed only by experts, not by gym trainers or nutritionists. Recognising obesity as a disease is the first step toward effective management. India needs policy changes, such as stricter sugar regulations in beverages, tax cuts on healthy foods, and mandatory nutrition education in schools. Teaching people to read food labels can promote healthier choices. A holistic approach combining medical treatment, policy reforms, and education can significantly combat obesity in India."
Question of affordability
The affordability of the recently launched Eli Lilly drug Mounjaro remains a big question. The drug is priced at Rs 3,500 for a 2.5 mg vial and Rs 4,375 for a 5 mg vial. This leads to a monthly cost between Rs 14,000 and Rs 17,500, depending on the prescribed dosage.
Mounjaro is an expensive drug requiring long-term use. Its accessibility in India—where healthcare expenses are largely out-of-pocket—raises questions about its feasibility as a mainstream treatment.
A Journal of the American Medical Association (JAMA) Network study suggests that these diabetes medicines (generic) could be produced at a fraction of the cost. If Indian manufacturers develop semaglutide and tirzepatide in pre-filled syringes with varying dose strengths, healthcare providers would be able to adjust dosages as needed—potentially increasing accessibility for those who need these treatments the most.
Alternative means
With the rising side effects and affordability of these drugs in question, alternative means to reduce obesity can be explored. Many experts are advocating for lifestyle modifications. Dietary changes, regular workouts, behavioural interventions, alternative medicines, etc., can do wonders if taken appropriately.
Unlike synthetic drugs, which often target a single mechanism, nutraceuticals offer a multidimensional approach. Says Amit Srivastava, Founder and Chief Catalyst, Nutrify Today, “These drugs often operate by suppressing hunger rather than correcting metabolism. So, while the kilos drop, the root cause—metabolic dysfunction—often remains unaddressed. Long-term reliance on these drugs without lifestyle and nutritional interventions may not deliver sustainable outcomes.”
Nutrify-Today, through NutrifyGenie AI, focuses on head comfort and improved quality of life, and another is dedicated to endurance for individuals with sugar concerns. Dealsphere is another AI-powered B2B nutraceutical deal discovery platform.
Clinically tested probiotics and prebiotics have solved obesity through Natural GLP-1 activation —without the adverse side effects commonly associated with weight-loss drugs. The Good Bug’s Advanced Metabolic System is the latest advancement in natural GLP-1 science, offering a sustainable and science-backed solution to weight loss. The company claims 12 per cent weight loss in 90 days.
Says, Keshav Biyani, Co-founder, The Good Bug, “Developed through cutting-edge gut microbiome research, the Advanced Metabolic System is a proprietary blend of clinically tested probiotics and prebiotics solving for obesity through Natural GLP-1 activation —without the adverse side effects commonly associated with weight-loss drugs. With the launch of this product, validated through scientific clinical trials, we are proud to offer a global first-of-its-kind innovative solution that delivers up to 12 per cent weight loss in 90 days.”
A well-balanced, plant-based diet has been scientifically proven to improve insulin sensitivity, reduce inflammation, and help with long-term weight loss. Various clinical trial studies found that participants following a low-fat, plant-based diet lost an average of 12 kg over six months and kept it off at 12 months.
Dr M K N Manohar, Senior Consultant, Manipal Hospitals, mentions, “Obesity has become a silent pandemic, accelerated by COVID. There is a wide gap between lifestyle changes and invasive treatments like surgery. Scientific evidence increasingly highlights the gut microbiome as a cornerstone of metabolic health and sustainable weight management.”
Educating consumers about natural GLP-1 boosters, raising awareness of gut microbiome science, and shifting the focus from symptomatic treatments to root-cause solutions are crucial for fostering trust and encouraging informed decisions.
As Dr Balaji Jaganmohan, Consultant Diabetologist, Apollo Sugar, Bengaluru, points out, “Rather than just addressing symptoms, weight management strategies should prioritise long-term health benefits. Natural GLP-1 boosters, when combined with lifestyle modifications and medical guidance, can be a crucial part of a comprehensive approach. However, their effectiveness requires rigorous scientific validation for widespread acceptance. Bridging the gap between conventional medicine and natural interventions through education, research, and awareness will empower individuals to make informed, sustainable health choices.”
Long-term solution
All pharmaceutical drugs are known to have some side effects. Pharma companies sometimes try to push their products while engaging in unethical practices to lure doctors into prescribing drugs. Whether the drugs do good or harm seems to be no one’s business.
The anti-obesity drugs market is huge, as the number of obese patients in India suggests. A quick way to shed the extra weight is the new norm. Various social media posts about losing weight are a dangerous precedent that plays with the emotions of obese people. On the other hand, popping pills is not at all a good option.
A holistic, research-based approach that integrates natural solutions, education and long-term health strategies is essential for managing obesity in India. Hence, lifestyle changes and long-term treatments by avoiding medicines that can create severe side effects will help many overcome the obesity challenges.
Activist S Srinivasan, Founder, Low Cost Standard Therapeutics (LOCOST) and Co-convenor, All India Drug Action Network (AIDAN), mentions that there seem to be many takers for tirzepatide. Desperate patients are willing to gamble despite knowing its adverse effects. Also, the affordability of the drugs needs to be looked into.”
Eli Lilly, with its recently launched anti-obesity drug and Novo Nordisk’s Wegovy might become a game changer in anti-obesity treatment, provided the companies come clean on the side effects and bring in more affordable drugs to India.
Sanjiv Das
sanjiv.das@mmactiv.com
