In closed groups and online forums, users share information about dosages, exchange sourcing tips, and discuss methods for storing low-cost vials of GLP-1 drugs. Offline, individuals are increasingly approaching clinics specifically asking for these medications by name, with queries including, “I want GLP-1,” or “which is better… Ozempic or Mounjaro?”
According to senior endocrinologist Dr. V Kumaravel, this marks a significant shift from the past when patients preferred oral medications due to “injection-phobia.” Dr. Kumaravel, who is based in Madurai and affiliated with the Endocrine Society of Tamil Nadu, observes, “People are now outrightly asking for these drugs by name.”
Despite warnings from the Union Health Ministry and healthcare professionals about the potential side effects associated with GLP-1 drugs—such as semaglutide and tirzepatide—there has been a considerable rise in the availability of generic versions following the patent expiration of semaglutide in late March. Local drug manufacturers have launched over 25 generic brands, offering products at prices 50 to 80 percent lower than original formulations like Ozempic and Wegovy. Monthly costs have decreased from ₹10,000–₹17,000 to as low as ₹1,290, with the lowest price point attributed to Natco Pharma.
On the other hand, Lilly’s Mounjaro remains under patent, retailing at ₹15,000 to ₹20,000, and continues to be the leading choice in this category.
However, medical professionals caution that the demand for GLP-1 drugs is largely influenced by factors outside traditional medical frameworks. Dr. Kumaravel notes that many patients arrive at clinics after seeing promotions on social media platforms, eager to secure these drugs without fully understanding their implications. He observes that the number of inquiries about GLP-1 medications is “multiple times higher” than the number diagnosed and prescribed the treatment.
This trend is further fueled by gyms and wellness clinics, along with recommendations from peers online and offline, according to another physician working in a tier-2 city. Users actively seek advice on drug sourcing, dosage adjustments, managing side effects, and diet, which ideally should be discussed with medical professionals. There are also instances of personal before-and-after photographs circulating, along with shared experiences that illustrate the drugs’ effectiveness. Some individuals even attempt to circumvent the prescription requirement altogether.
Dr. Kumaravel highlights that prior to the advent of GLP-1 medications, options for obesity management were quite limited, with doctors primarily recommending diet and exercise, which often proved ineffective for many. He explains, “When GLP drugs came in, they entered with strong efficacy.”
In India, these drugs can only be prescribed by endocrinologists, internal medicine specialists, and cardiologists, specifically for individuals with a Body Mass Index (BMI) of 25 or above, particularly those with metabolic risk factors or co-morbidities. According to the definition, obesity is indicated by a BMI of 25 kg/m² or higher.
A Mumbai-based user of GLP-1 (who chose to remain anonymous) shared, “I got really tired of working hard and still not losing weight… Then I saw how much GLP-1s helped people, especially with PCOS. There are many side effects, so I was hesitant. But I decided to pick my struggle, considering I was already living with a different set of side effects.”
The side effects, which include nausea, vomiting, bloating, and diarrhea, have not deterred new users. One individual remarked, “Even with all the awful side effects like insomnia and constant diarrhea, if this is the kind of progress I’m getting, I’ll take it any day.”
Global health authorities have also warned about potential serious side effects such as vision loss, kidney failure, and thyroid cancer. Dr. Kumaravel noted that one of the initial reported side effects of semaglutide was sudden blindness, identified as non-arteritic anterior ischemic optic neuropathy. He expressed concern that mass usage may lead to oversight of these risks.
Furthermore, doctors emphasize that rapid weight loss may be accompanied by muscle loss if not properly monitored. Dr. Kumaravel stated, “When you lose weight, it is not only fat—you lose muscle as well.” He strongly opposes off-label use of these drugs, describing them as a “double-edged sword.”
Even among those who successfully reach their weight goals, reports of renewed cravings and weight gain after discontinuation of GLP-1 drugs are common.
GLP-1 drugs are designed to treat obesity and type 2 diabetes by mimicking a naturally occurring hormone that regulates blood sugar and appetite. They increase insulin secretion, reduce glucagon release, slow gastric emptying, and promote satiety, which helps patients consume less food.
The market for these medications in India is estimated at ₹5,000 crore, with various options available including semaglutide injections, tablets, liraglutide, tirzepatide, dulaglutide, exenatide, and exenatide extended release.
Jitendra Chouksey, Founder-CEO of health platform FITTR, remarked that GLP-1s were never intended to replace a healthy lifestyle. He questioned, “If these drugs were truly helping, wouldn’t we have seen a reduction in obesity prevalence globally?” He pointed out that while there may be short-term impacts, long-term adherence remains low, and obesity rates continue to climb worldwide.
Chouksey also warned of cardiovascular issues following the discontinuation of the drugs, referencing a recent study that indicated a rapid decline in cardiac health after users stop taking GLP-1 medications, suggesting up to a 22% deterioration within 18 months. He cautioned that the absence of sustained benefits, often termed a “legacy effect,” raises concerns about long-term dependence on the drugs.
Dr. Kumaravel voiced his concern over the shifting dynamics of medical decision-making, stating, “The decision (to use GLP-1s) has now moved from a doctor’s place to a consumer market.” He noted that while healthcare authorities can regulate medical practices, managing consumer behavior poses greater challenges.
