GLP1-RA and Weight Loss Boom in India – Trends, Concerns and Caution – Dr. Amit Bhargava, Dr. Varsha Narayanan

The Weight Loss Revolution in India: Beyond the Hype

India is experiencing a surge in demand for weight loss medications, particularly GLP-1 receptor agonists (GLP1-RAs) like semaglutide and tirzepatide. The recent patent expiry of semaglutide has opened the door to a flood of generic versions, promising significantly lower prices. But this boom raises critical questions about responsible prescribing, patient safety, and the role of lifestyle interventions.

The Rise of GLP1-RAs: A “Magic Pill Moment”?

Semaglutide, initially known as Ozempic for type 2 diabetes, gained immense popularity for its weight loss effects. Now, with generic versions entering the Indian market, analysts predict a potential price drop of up to 90 percent, potentially growing the market to $1 billion. This accessibility is transformative, especially in a country grappling with rising obesity rates and a large diabetes population.

Tirzepatide: The Next Generation

While semaglutide generics are poised to dominate the lower price segment, tirzepatide (Mounjaro, Yurpeak) – a dual GLP1 and GIP receptor agonist – is maintaining a premium price point. Eli Lilly, the manufacturer, believes there’s room for both branded innovator drugs and generics, citing tirzepatide’s potentially superior efficacy. Studies suggest tirzepatide may lead to greater weight loss (20-22 kg on average) and improved glucose control compared to semaglutide (16-18 kg).

Prescribing with Caution: Risks and Responsibilities

Despite their effectiveness, GLP1-RAs aren’t without risks. Common side effects include gastrointestinal issues, and more serious concerns involve potential renal dysfunction, pancreatitis, and gallbladder disease. Regular monitoring for adverse effects, including ophthalmic retina screening and assessment of muscle loss, is crucial. These medications should not be viewed as a “one-size-fits-all” solution, but rather as part of a comprehensive treatment plan.

Individualized prescribing decisions, based on thorough patient evaluation and lifestyle factors, are paramount. Healthcare providers should prioritize patient-centered initiation, baseline screening (dietary habits, emotional triggers), comprehensive physical examinations, and lifestyle assessments (exercise, sleep, stress levels).

The Importance of Lifestyle Intervention

While GLP1-RAs can produce significant short-term weight loss, exercise remains vital for maintaining lean mass, cardiorespiratory fitness, and long-term health. Studies show that weight regain is common after stopping medication alone, whereas the benefits of exercise are more sustained. A combined approach – pharmacotherapy and lifestyle changes – is the most effective strategy.

A Concerning Trend: OTC Oral GLP1-RAs

The recent approval of Korglutide, an oral GLP1 and IGF1 RA, as an over-the-counter (OTC) “functional food supplement” in India is raising serious concerns. The clinical trial data supporting its approval is limited, lacking peer review and long-term safety evaluations. The pharmaceutical industry has questioned the study design and the accuracy of the results. Approving a drug with insufficient evidence, bypassing rigorous scientific review, sets a dangerous precedent.

FAQ: GLP1-RAs in India

Q: Are GLP1-RAs safe for everyone?
A: No. They have potential side effects and are not suitable for individuals with certain medical conditions. A thorough medical evaluation is essential.

Q: Can I get GLP1-RAs without a prescription?
A: While generics are becoming more accessible, a prescription from a qualified healthcare professional is still recommended to ensure safe and appropriate use.

Q: Is Korglutide a safe alternative to established GLP1-RAs?
A: The safety and efficacy of Korglutide have not been adequately established through rigorous scientific research. Caution is advised.

Q: What is the role of diet and exercise?
A: Diet and exercise are fundamental to successful weight management and should be prioritized alongside any medication.

The Indian weight loss market is evolving rapidly. While increased access to GLP1-RAs offers hope for many, responsible prescribing, patient safety, and a continued emphasis on lifestyle interventions are crucial to ensure a healthy and sustainable future.

References

1. Zheng, Z., Zong, Y., Ma, Y. et al.Glucagon-like peptide-1 receptor: mechanisms and advances in therapy. Sig Transduct Target Ther 2024; 9, 234.
2. Li H, Yu G, Huang Q, Yang B, Nie J, Liu Y, Tu X. Efficacy and safety of GLP-1RAs for people with obesity: A systematic review based on RCT and Bayesian network meta-analysis. Biomed Pharmacother. 2024 Feb;171:116150.
3. Jensterle M, Rizzo M, Haluzík M, Janež A. Efficacy of GLP-1 RA Approved for Weight Management in Patients With or Without Diabetes: A Narrative Review. Adv Ther. 2022 Jun;39(6):2452-2467.
4. Rivera FB, Cruz LLA, Magalong JV, Ruyeras JMMJ, Aparece JP, Bantayan NRB, Lara-Breitinger K, Gulati M. Cardiovascular and renal outcomes of glucagon-like peptide 1 receptor agonists among patients with and without type 2 diabetes mellitus: A meta-analysis of randomized placebo-controlled trials. Am J Prev Cardiol. 2024 May 7;18:100679.
5. Aronne LJ, Horn DB, le Roux CW, Ho W, Falcon BL, Gomez Valderas E, et al. SURMOUNT-5 Trial Investigators. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. N Engl J Med. 2025 Jul 3;393(1):26-36
6. Rodriguez PJ, Goodwin Cartwright BM, Gratzl S, et al. Semaglutide vs Tirzepatide for Weight Loss in Adults with Overweight or Obesity. JAMA Intern Med.2024;184(9):1056–1064.
7. Ghusn W, Hurtado MD. Glucagon-like Receptor-1 agonists for obesity: Weight loss outcomes, tolerability, side effects, and risks. Obes Pillars. 2024 Aug 31;12:100127.
8. Mittal A. India’s GLP-1 Boom: Tread with caution. India Today [online]. 17^th February 2026. Available from https://www.indiatoday.in/health/story/indias-glp-1-boom-tread-with-caution-2869033-2026-02-16
9. Mozaffarian D, Agarwal M, Aggarwal M, Alexander L, Apovian CM, Bindlish S, et al. Nutritional priorities to support GLP-1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society. Obesity (Silver Spring). 2025 Aug;33(8):1475-1503
10. Codella R, Senesi P, Luzi L. GLP-1 agonists and exercise: the future of lifestyle prioritization. Front Clin Diabetes Healthc. 2025 Nov 24;6:1720794
11. Jensen SBK, Blond MB, Sandsdal RM, Olsen LM, Juhl CR, Lundgren JR, et al. Healthy weight loss maintenance with exercise, GLP-1 receptor agonist, or both combined followed by one year without treatment: a post-treatment analysis of a randomised placebo-controlled trial. EClinicalMedicine. 2024 Feb 19;69:102475.
12. Mun-hee C. Caregen Completes Registration of GLP-1 Peptide ‘Korglutide’ in India. Business Korea [Online]. July 30^th, 2025. Available from https://www.businesskorea.co.kr/news/articleView.html?idxno=248443
13. WHO-International Clinical Trials Registry Platform. Clinical Study of Korglutide in Weight Management in Obese Individuals With and Without Type 2 Diabetes. April 7^th, 2025. Available from https://trialsearch.who.int/Trial2.aspx?TrialID=CTRI/2025/01/078994
14. Hyun-a Y. Caregen claims Korglutide surpasses Wegovy in weight loss effectiveness. Chosun Biz EN [Online]. July 31^st, 2025. Available from https://biz.chosun.com/en/en-science/2025/07/29/VGTXK3RNHFGH7FO3H4GYDXE3UQ/