The landscape of pharmacological obesity treatment is rapidly changing, requiring healthcare providers to stay updated. With a growing selection of weight loss medications available, patients often inquire about the strongest or most effective options and which is best suited for them. The answer is complex, and newer isn't always better. In India, where 1 in 4 adults are classified as overweight or obese according to the NHFS-5 (National Family Health Survey), the introduction of new anti-obesity drugs marks a significant development. This article aims to provide a detailed overview of weight loss medications available in India, their efficacy, cost, and potential side effects.
Determining Candidacy for Weight Loss Medications
The initial step in determining whether someone is a candidate for weight loss medications begins with assessing their Body Mass Index (BMI). Guidelines for medications like tirzepatide (Zepbound) and semaglutide (Wegovy) typically require a BMI of 30 or a BMI of 27 with weight-related health problems. It's crucial for doctors and patients to discuss the patient’s current health issues, other medications, and family medical history on a case-by-case basis.
Approved Weight Loss Medications in India
Several weight loss medications have gained traction in the Indian market, each with its unique mechanism of action, efficacy, and cost. Here's a detailed look at some of the key players:
1. Semaglutide (Wegovy, Rybelsus, Ozempic)
- Wegovy: This is a brand name for semaglutide, a GLP-1 receptor agonist. It was FDA-approved in 2021 and launched in India in June 2025. Wegovy is administered as an injection and is approved for use in adults and children aged 12 years or more with obesity (BMI ≥30 for adults, BMI ≥ 95th percentile for age and sex for children) or some adults with excess weight (BMI ≥27) who also have weight-related medical problems. The dose must be increased gradually over 16 to 20 weeks to arrive at the 2.4 mg dosage. This progression can help alleviate side effects, which include gastrointestinal symptoms, headache, dizziness, and fatigue. It is intended to be used indefinitely, in combination with a healthy diet and exercise. In India, Wegovy is available in five strengths: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg.
- Cost: The 0.25 mg, 0.5 mg, and 1 mg versions are priced at ₹4,336.25. The monthly cost would be ₹17,345, similar to Mounjaro. The 1.7 mg dose is priced at ₹24,280, and the 2.4 mg version at ₹26,015 for a month's supply.
- Rybelsus: This is an oral semaglutide drug launched in India in January 2022. It is primarily used for diabetes treatment but may help with some weight loss. Rybelsus has grown significantly, commanding a substantial share of the GLP-1 market.
- Cost: The monthly cost comes to approximately ₹10,000.
- Ozempic: This is an injectable form of semaglutide, primarily used for managing type 2 diabetes. While it can lead to weight loss, it is not officially approved or available in India specifically for weight loss.
- It's important to note that some online healthcare providers may claim to sell Ozempic, Wegovy, or Zepbound at reduced prices. However, the FDA warns against buying medications from any source other than a state-licensed pharmacy due to the risk of counterfeit products.
Semaglutide mimics the natural hormone GLP-1, produced by the gut, primarily targeting the brain to reduce appetite and cravings. It also reduces gastric emptying, leading to increased satiety. Studies also suggest potential benefits in reducing alcohol and tobacco cravings. Beyond weight loss, semaglutide offers additional health benefits, including reduced abdominal obesity, improved blood glucose control, lower blood pressure, and beneficial effects on lipid profiles.
2. Tirzepatide (Mounjaro, Zepbound)
- Mounjaro: Eli Lilly & Co. launched its anti-obesity drug, Mounjaro (Tirzepatide), in India in March 2025. Mounjaro's active ingredient, tirzepatide, has captured a notable percentage of the market in India. The Central Drugs Standard Control Organisation approved Mounjaro's six dose strengths of 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg and 15 mg. According to data compiled, Mounjaro recorded significant sales in its initial months.
- Cost: A 2.5 mg vial of Mounjaro is priced at ₹3,500, and a 5 mg vial at ₹4,375, translating to ₹14,000-17,500 per month depending on weekly dose. A six-month treatment could cost about ₹1 lakh.
- Zepbound: In the US, the FDA has approved tirzepatide for weight loss under the brand name Zepbound. However, in India, the Tirzepatide Molecule is marketed only under the name "Mounjaro," not registered as Zepbound.
Tirzepatide is a dual GIP and GLP-1 receptor agonist that suppresses appetite, improves satiety, and supports metabolic health. In clinical trials, adults taking tirzepatide achieved significant average body weight reduction. Studies also show improvements in cardiovascular risk factors and metabolic markers.
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3. Liraglutide (Saxenda, Victoza)
Liraglutide is a daily injectable medication that acts on hormones that send signals from the gut to the brain, making the patient feel full quicker and decreasing hunger signals. Doses start at 0.6 mg to 3 mg a day. Some patients may lose 5-10% of body weight, especially with the higher dose of liraglutide. Liraglutide is also approved for Type 2 Diabetes, under the brand name Victoza.
4. Phentermine
Phentermine is the oldest and most widely used weight loss medication. It was originally used as a short-term medication to jump-start weight loss, but now newer medical guidelines have added it to long-term therapy.
5. Phentermine-Topiramate (Qsymia)
Topiramate can be combined with phentermine to decrease appetite and cravings. Adults with migraines and obesity are good candidates for this weight-loss medication. Some patients may lose an average of 5-10% of body weight.
6. Naltrexone-Bupropion (Contrave)
Naltrexone-bupropion combines an opioid receptor antagonist with an antidepressant to affect the pleasure-reward areas of the brain and thereby decrease cravings and appetite.
7. Orlistat (Xenical, Alli)
Orlistat is a lipase inhibitor that comes in a capsule. Undigested fat is then passed through the body. Some patients may lose about 5% of their body weight. An over-the-counter formulation is available at 60 mg capsules with each fat-containing meal. The only over-the-counter medicine for weight loss currently approved by the FDA is Alli (orlistat).
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8. Setmelanotide (Imcivree)
Setmelanotide is a melanocortin-4 receptor agonist indicated for chronic weight management in adult and pediatric patients six years and older with obesity due to certain rare genetic disorders.
9. Plenity
A medical device rather than a medication, Plenity was FDA-cleared in 2019 for people with a BMI of 25 to 40. It consists of a capsule that releases a biodegradable, super-absorbent hydrogel into the stomach. The gel helps to increase satiety, enabling the person to eat less.
Generic Medications and Market Dynamics
The Indian pharmaceutical industry is gearing up for a significant shift with the impending patent expirations of GLP-1 receptor agonists like semaglutide. Key patents for semaglutide are set to expire around January 2026 in some regions and sometime next year in India, potentially triggering a generics boom. Indian pharmaceutical companies like Dr. Reddy's, Sun Pharma, Cipla, Biocon, and Lupin are actively developing their own generic versions, aiming for market entry as early as 2026 once key patents expire.
The Indian government is actively supporting domestic pharmaceutical manufacturing through its Production-Linked Incentive (PLI) scheme, which aims to boost the production of complex drugs, including GLP-1 receptor agonists. This support, combined with patent expirations, is intended to position India as a major global exporter of affordable generic GLP-1s.
Side Effects, Risks, and Precautions
While anti-obesity drugs can be effective for weight loss, they may also carry potential risks and side effects, and their long-term safety is still being evaluated. Common side effects include nausea, vomiting, diarrhea, constipation, headache, and dizziness. More serious side effects can occur rarely, making it important to discuss all treatment choices with a healthcare provider.
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It is crucial to note that weight-loss drugs are not for everyone. They should not be taken if you're trying to get pregnant, are pregnant, or are breastfeeding. Older AOMs also have indications based on BMI and may be contraindicated for use with certain other medications.
Semaglutide is not to be prescribed in the following situations:
- Type-1 diabetes
- Pancreatitis history
- Presence of gall bladder stones
- Moderate to severe retinal/macular disease in patients with type-2 diabetes
- Presence of family or personal history of Medullary thyroid cancer or MEN 2 syndrome
- Patients with gastroparesis
To minimize side effects, it's important to start with the lowest possible dose and gradually increase it as per the pack insert. Small, frequent meals, proper hydration, and avoiding fatty/oily meals can also help alleviate nausea.
Comprehensive Approach to Weight Management
It is important to view weight loss medications as part of a comprehensive approach, including dietary changes, physical activity, and regular medical supervision. A treatment plan for obesity can comprise multiple forms of treatment, including medications, diet, exercise, and/or surgery. All weight loss medications work best in the context of a healthy eating plan and exercise. In addition to prescription medications, certain vitamins and supplements, like calcium and vitamin D, may help support metabolic health.
The Future of Weight Loss Medications in India
With fervent consumer demand for weight loss medications, combined with rising obesity rates, more medications are bound for the market in the coming years. Pharmaceutical platforms predict new GLP-1 launches annually. Researchers continue to study hormones that play a role in appetite for other ways to target obesity with medication, including GLP-1, peptide tyrosine-tyrosine (PYY), and cholecystokinin (CCK). With more options available, doctors will be increasingly able to personalize treatments.