Cheaper weight-loss drugs raise safety concerns
Diabetologists and general physicians in India are not yet confident about recommending these new medications to their patients
ON March 10, this year, India's drugs controller, in collaboration with state regulators, initiated action to curb possible malpractices in the pharmaceutical supply chain and prevent the unauthorised sale and use of weight-loss drugs whose generic versions were recently launched in India, leading many to consider them a panacea.
The market has been inundated with so-called 'miracle' solutions for diabetes control and weight loss. However, noted for their potential in combating obesity, weight loss drugs may have implications beyond their intended purpose.
Recent research suggests these medications could have effects on behavioural patterns, particularly those related to addiction.
Clinicians have observed that some individuals taking weight-loss medications for conditions such as type 2 diabetes or obesity exhibit reduced tendencies towards addictive behaviours, including alcohol consumption, tobacco use and even compulsive shopping. Weight-loss drugs have a long history, and the therapeutic effects and adverse reactions of conventional drugs are well known.
The relationship between weight-loss drugs and dependency remains complex and not fully understood. While studies suggest that GLP-1 receptor agonists might help reduce cravings, it is not clear if this effect translates to a higher risk of dependency.
No studies have examined the experiences of semaglutide users beyond the side effects documented in efficacy studies. The potential for misuse and dependency is under investigation, and more research is needed to fully understand the implications of these drugs. This makes medical supervision essential, not optional.
The surge in generic medicine launches occurred because the patent protection in India for semaglutide, the key active ingredient used in Ozempic and Wegovy — the diabetes and anti-obesity medications manufactured by Danish pharmaceutical company Novo Nordisk — expired on March 20, 2026.
Consequently, these medications for combating diabetes and obesity are now more readily available and significantly cheaper.
While public response to these drugs is proving to be a "gold mine" for pharmaceutical companies, the use of these drugs without prescription is likely to cause complications and ultimately force consumers to seek medical help.
A study on 'The Ethics of Ozempic and Wegovy' published in the November 2025 edition of the Journal of Medical Ethics, addresses related ethical concerns. But it does not provide conclusive reasons for not prescribing semaglutide for weight loss. These drugs are increasingly being seen as 'miracle' treatments and have gained popularity.
Since mid-March, more than a dozen Indian pharmaceutical companies launched affordable generic versions of these anti-diabetic-cum-weight loss medications in the market. They are now available in both liquid and tablet forms. The cost of vial-based drugs starts around Rs 1,290, whereas that of premium pre-filled pens goes up to Rs 8,000. Although generic drugs are driving the prices down, original branded medications continue to dominate the premium segment of the market — both in pricing and market positioning.
GLP-1 (Glucagon-like Peptide-1) receptor agonists are just the start of modern anti-obesity treatments. It took over 20 years to develop these drugs, and in the next decade, many patents for other obesity medicines will expire, making effective treatments more affordable. Currently, 193 potential anti-obesity drugs are under development.
These new medications work by targeting hormones that control appetite and metabolism via the brain. Dual-agonist drugs, like tirzepatide, activate two hormone receptors: GLP-1, which reduces appetite and slows digestion, and GIP, which improves insulin function. Together, they lead to greater weight loss than single-hormone therapies.
Some GLP-1 combinations, such as semaglutide and cagrisema, add other hormones like Amylin, which also slows digestion and controls appetite. This multi-hormone approach mimics natural satiety signals to boost weight loss and improve metabolism. The study of these complex hormonal systems, including glucagon's role in burning stored energy, has been advancing since the 1980s.
Oral GLP-1 medications claim to offer benefits comparable to injectable therapies and are available in pill form. This eliminates the need for weekly injections, refrigerated storage of the medication and constant supervision by a specialist.
Therefore, the danger comes not from the drug itself but from a lack of monitoring by a specialist. While the intake of these medications independent of a physician's observation could significantly rise due to their easy availability in the market, it is also likely to lead to an increase in resultant complications.
The next shift in the treatment of obesity may manifest not merely in the form of more affordable medications, but also through novel therapeutic formats. Several next-generation therapies are currently in the final stages of clinical trials. However, it will still take a few more years before they become available in the Indian market.
Notably, diabetologists and general physicians in India are not yet confident about recommending these new medications to their patients. Doctors hold regular discussions about the efficacy of new drugs. Pharmaceutical companies, too, often organise seminars and discussions for them. However, some doctors consider this practice unethical. They await research literature or recommendations from the Indian Council of Medical Research or the drug controller.
The approval of these drugs for sale in India means doctors may prescribe them based on professional judgment.
