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India's weight-loss drug boom sparks medical and ethical concerns
Mumbai diabetologist Rahul Baxi now fields daily inquiries from young professionals seeking prescriptions for weight-loss drugs-originally developed for diabetes-amid a surge in demand fueled by social media and corporate stress. The 23-year-old corporate employee who recently asked for help shedding 10 kg gained from a high-pressure job is just one example of a broader trend sweeping urban India, where over 77 million people live with Type 2 diabetes and obesity rates climb.
How GLP-1 drugs reshaped weight loss
Drugs like semaglutide (sold as Rybelsus and Wegovy by Novo Nordisk) and tirzepatide (Eli Lilly's Mounjaro) dominate India's market, mimicking hormones to suppress appetite and slow digestion. Administered via weekly self-injections, they deliver rapid results-often within weeks-but doctors warn of rebound weight gain, muscle loss, and side effects ranging from nausea to pancreatitis. "These are the most powerful weight-loss drugs we've ever seen, but they're not magic bullets," says Anoop Misra, director of Delhi's Fortis-C-DOC diabetes center.
India's obesity drug market has ballooned from $16 million in 2021 to nearly $100 million today, per Pharmarack. A single monthly pen (four doses) costs ₹14,000-27,000 ($157-300), pricing out most Indians-but that may change in March 2026, when semaglutide's patent expires. Analysts predict a flood of cheaper generics could push the market to $1 billion, raising fears of misuse.
Risks of unsupervised use
Doctors report alarming trends: gym trainers prescribing high doses, online pharmacies dispensing drugs after cursory phone calls, and beauty clinics offering "bridal packages" for rapid slimming. "Affordability will improve, but so will misuse," warns Sheetal Sapale of Pharmarack. Federal health minister Jitendra Singh has urged caution, while Mumbai physician Bhaumik Kamdar recalls a father asking if the drugs could help his daughter lose 7 kg before her wedding-"in three months."
Obesity as disease, not lifestyle choice
India's cultural perception of obesity complicates treatment. "Many see it as prosperity, not a chronic disease linked to 20+ cancers, infertility, and fatty liver," says bariatric surgeon Muffazal Lakdawala. While GLP-1 drugs have shifted conversations toward medicalizing obesity, doctors stress they're no substitute for diet and exercise. "Cut sugar, exercise four days a week-no injections needed for 5-7 kg loss," Lakdawala advises.
Beyond cosmetics: Medical applications expand
Specialists now prescribe weight-loss drugs for non-cosmetic uses: cardiologists for heart patients pre-angioplasty, orthopedic surgeons pre-knee surgery, and chest physicians for sleep apnea. "For CPAP-averse patients, weight loss can unblock airways," notes Dr. Kamdar. Bariatric surgery programs, too, have evolved-Lakdawala's clinic first tries drugs with multidisciplinary support before considering surgery for severe cases.
Regulatory and ethical gray zones
With generics looming, experts fear a black market boom. "We've seen colleagues prescribe thousands of doses-many sourced illegally," says a Delhi physician. Novo Nordisk's Rybelsus holds 60%+ of India's market, but Eli Lilly's Mounjaro (launched in 2025) is fast catching up. The drugs' dual use-diabetes treatment vs. lifestyle enhancement-blurs ethical lines. "If you're not obese or diabetic, why risk side effects for vanity?" asks Dr. Baxi. Yet for many, the allure of rapid results outweighs warnings.
"Obesity is a relapsing disease. Crash diets fail 99% of the time. These drugs offer hope-but only with lifelong changes."
Dr. Muffazal Lakdawala, bariatric surgeon
