The Do’s and Don’ts of Weight-loss Drugs
1 Aug 2025 6:20 PM IST
Description: Next year, Novo Nordisk’s patents for semaglutide — the key ingredient in weight-loss drugs Ozempic and Wegovy — will expire in India. Indian pharmaceutical companies are already racing to develop generic versions.
Right now, these drugs cost anywhere between Rs 17,000 and Rs 26,000 per month. But generics could cost up to 90% less, according to some estimates.
That means many more people in India could soon have access to semaglutide. But should you actually take it?
In today’s episode of The Signal Daily, we break down how these drugs work, who they’re for, and why some people should avoid them.
The Core produces The Signal Daily. At The Signal Daily, we don’t do hot takes, instead we bring you deep dives into the how and why of consumer trends.
To check out the rest of our work, go to www.thecore.in. Thank you for listening!
The Core produces The Signal Daily. Find us wherever you get your favourite podcasts. To check out the rest of our work, go to www.thecore.in
NOTE: A machine transcribed this episode. A human has looked at this text but there might still be errors. Please refer to the audio above, if you need to clarify something. If you want to give us feedback, please write to us at [email protected].
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TRANSCRIPT
Kudrat (Host): Early next year, the patent of several GLP-1 or glucagon-like peptide-1 drugs will expire in the Indian market. Here, I'm referring specifically to Novo Nordisk's medicines, sold under the brand name Ozempic and Bagovi. These are injectable drugs that patients use once a week.
In India, they cost anywhere from 17,000 to 26,000 rupees a month. With their patent expiring, several Indian brands like Dr. Reddy's and Cipla are now rushing to make generic versions, which according to some estimates, could be 90% cheaper than brand name Ozempic and its ilk. Already, there's a big hype for these GLP-1 drugs.
That's because they show clear, measurable results. In the past year, some people in Bollywood have lost a drastic amount of weight. Though they haven't come out and said so, many on social media are speculating that they're on Ozempic.
Semaglutide have truly miraculous results, especially for obese and overweight people with comorbidities like diabetes. Indian companies will soon come out with generics, meaning this drug will become accessible to many more people in the country. But how does it really work? Who should take it and who should avoid it?
Kudrat (Host): I'm your host Kudrat Wadhwa and you're listening to The Signal Daily. We don't do hot takes. Instead, we bring you deep dives into the how and why of consumer trends. In today's episode, we learn about how Semaglutide drugs work. What are the do's and don'ts of these weight loss drugs?
Anika: hi, my name's Anika. I am 22 years old and I started my GLP one medication in I believe, June.
I have struggled with weight gain my entire life. Uh, and I've tried diets, I've tried exercises, I've tried even, uh, lower versions of GLP one medication and, um. It just did not have any effect. I would lose a couple of kgs and then I would bounce right back.
Kudrat (Host): Anika said that she has PCOS, meaning polycystic ovarian syndrome, and is pre-diabetic too. When she went to doctors for a consultation, they would always tell her to lose weight. PCOS basically means that you've developed cysts on your ovaries. It's a relatively common disease among Indian women. With both PCOS and pre-diabetes, the body struggles to regulate insulin levels, and that's why losing weight can help a lot. But Anika found this advice to be disappointing. She'd already heard it from so many people. She'd tried to lose weight so many times and had not been as successful. But since she started GLP-1, she said she's already lost 6 kgs in the last 2 months.
Anika: And that really helps in the diet aspect because then I'm not eating as much. The progress has been better than before so I really feel like in a year I will have much more of a sustainable lifestyle in terms of diet and exercise and also in terms of weight because I also have a lot of medical issues and I hope and I pray that a year or five years down the line I don't have those health issues anymore because I will be at a lower weight.
Kudrat (Host): According to the World Health Organisation, diabetes is a serious problem in India. The WHO estimates that 7.7 crore Indians above the age of 18 suffer from type 2 diabetes. About 2.5 crore are pre-diabetic, meaning that they're at a higher risk of developing diabetes in the future. Though obesity is a much bigger problem in more developed countries like the US, weight gain is increasingly becoming an issue in India as well. For context, if your BMI is above 25, you're overweight and if it's above 30, you would be considered obese. To calculate your BMI or body mass index, you divide your weight in kgs with the square root of your height in metres.
The National Family Health Survey from 2021 found that 24% of Indian women and 23% of Indian men are overweight or obese. The big reason for that is our intake of high-calorie, high-carbohydrate and low-nutrient foods as well as our sedentary lifestyles. For some, losing weight can be as simple as eating healthier and moving more. But for many, this process isn't as easy. Also, our modern lifestyles don't always allow for healthy behaviours either. A lot of our jobs are stressful and require sitting down and staring at a laptop for hours.
Kudrat (Host): Now, high-calorie and low-nutrient foods are also cheaper and readily available. It's so much more convenient to opt for those instead. And then genetics play a role here too. Some people, as I mentioned earlier, are just more prone to weighing more because of their family background. Obese individuals, in particular, also experience something called food noise, meaning persistent intrusive thoughts about food. And this is particularly where GLP-1 drugs like Ozempic and Wegovy are effective.
Originally, the scientists at Novo Nordisk, that's a Danish pharma company that first made Ozempic, saw semaglutide as a drug to manage diabetes. Essentially, the drug stimulates insulin release from the pancreas when your blood sugar spikes. That suppresses your body from releasing glucagon, a hormone that raises blood sugar. The drug also slows down digestion. Basically, taking it helps people manage their blood sugar and makes them feel full for longer. So they don't want to eat as much.
If you're already feeling full, chances are that you won't also think about food as much. And that's how it helps to calm down that food noise that I mentioned earlier. Semaglutide is not just effective for diabetes but also for weight loss. Now, semaglutide is definitely not the first weight loss drug to come into the market. But it's the first drug to show such clear results. Patients report losing 20-30% of their weight on it.
The Core’s Govindraj Ethiraj spoke to Sheetal Sapale, VP of Commercial at Pharmarack, a B2B e-commerce pharma platform, on why these drugs are flying off the shelves in India.
Sheetal Sapale: In recent years, after the SGLE-2s and DTP-4s, again, which were in the OED segment, in the anti-diabetes and the obesity segment, this is one of the fastest growing products. And the majority of the time, it happens because the market has been built very well. Awareness is good and consumption, and it's a global product, okay?
It's not that it's getting launched parallelly in India. It has already been in there globally. That's why people know about the efficacy of the product.
And that's why the pickup is very good.
Govindraj Ethiraj: Right. And within the weight loss segment, what are the drugs that are, let's say, growing faster? And what are the other trends that you're seeing within that?
Sheetal Sapale: See, in the obesity category, anti-obesity products category, we had a molecule Orlistat, which was not a GLP-1 agonist, but it's a molecule which existed for a pretty long time, which is there. It's around 100 crore, around 70-80 crore market today. But then it did not show that type of rapid growth.
Besides Orlistat, we have Semaglutide, Dulaglutide, Terzapitide, Liraglutide, of which Semaglutide, Terzapitide are the in things because of their efficacy and a good amount of global exposure. The drugs that were available, Orlistat, which was available earlier, the mode of action was reducing the fat absorption, which the Indian diet is more carb-rich. So it did not show that type of result.
But these products that have come in the market today, the GLP-1 agonist, have two, three modes of action wherein they suppress the feeling of hunger, they reduce the gut motility because of which you keep on feeling full for a longer period of time. And this has really given that weight loss output, which is quite satisfactory. You tend to lose at least 20-30% of your weight in the initial five to six months.
And that's the reason why these drugs seem to be pretty popular. Also, in terms of consumption, while Semaglutide tablets were once a day, every day, but then the newer pens or wires that are available, it's just a once a week injection. Again, the frequency of dosing is also very convenient for the people.
Kudrat (Host): Semaglutide's pathway and its convenience are what distinguish the drug and make it so popular. It'll soon become less pricey. But does that mean that you should go for it?
Sonali: I'm Dr. Sonali Kagne. I'm an endocrinologist, uh, consultant at Alliance Foundation Hospital. And, uh, presently, uh, we look after various, um, disorders related to diabetes, obesity, metabolic syndrome.
Kudrat (Host): Dr. Kagne said that about 10% of the people who come into her office asking for the drug don't qualify as overweight or obese.
Sonali: So basically, we have certain criterias, which are defined on the basis of the body mass index. So if someone who has a body mass index above 30 kg per metre square, or someone who has it about 27 kg per metre square, but they are having some other weight-related comorbidities, such as diabetes, hypertension, dyslipidaemia, or any high-risk family history, in that case, we can consider these GLP-1 receptor agonists. But for someone who is absolutely in a normal BMI or just overweight category, I would refrain myself from prescribing those medications.
Kudrat (Host): Dr. Kagne said for people in the normal or slightly overweight category, she recommends non-pharcological measures. Healthy eating, maintaining good sleep hygiene, exercising. That’s also because some users on semaglutide drugs experience side effects.
Sonali: Once we start these medications, depending upon the mechanism, they are going to have this, uh, side effects of, uh, nausea, vomiting, loose motion, constipation, but not necessarily all of them would've, most of the side effects.
So it depends on person to persons, but there are few patients in whom, uh, we have to discontinue the medication just because their body is not accepting that new molecule.
Kudrat (Host): Also, if you’re not exercising, you’d lose adipose tissue (that’s fat) but you’ll also lose muscle. To prevent that, doctors recommend that patients eat adequate protein and do weight training in addition.
Another thing to keep in mind is that some people have found that while they lost weight on the drug, they gained it all back once they stopped their weekly injections.
Sonali: so again, this is another important point that we should share that in the time these individuals are on these medications, their weight would start reducing and it'll be then maintained in that particular range.
And, uh, currently with whatever the studies are available, they, it, it has suggested that once you stop the medications within the next 1, 2, 3 years, you are going to regain the lost weight. Probably not a hundred percent, but again, depending upon the individual to individual, at least 80% of your lost weight can come back.
So therefore, it is important for us to decide whom to start it. And therefore these criteria about basically the benefits should be, uh, on the higher side compared to the side effects. Then only we need to start these medications. So many of them would have to take it for a longer period of time, probably.
Uh, very long time or lifelong. Okay. Uh, to sustain those beneficial effects of the injections lifelong, I mean, uh, depends upon their response and then their lifestyle modification, and we need to try, uh, weaning them off and see if they're putting on the weight or not. But there would be some certain category of people in which, in whom we have to probably continue for a very longer period of time.
Kudrat (Host): In the short term, some people experience nausea, vomiting, constipation on semaglutide in the short term. Scientists are still studying its long-term side effects, but some reports say that a very small percentage of users can develop pancreatitis, kidney issues, thyroid tumors and vision issues.
For that reason, Dr. Kangne is judicious with who she prescribes these to.
But, if you’re obese and experience co-morbidities like diabetes too, endocrinologists see GLP-1 drugs as a solid solution.
Sonali: And second important thing is for someone who has, like you mentioned, they have already tried many different things, but were unable to, uh, lose weight for one of the other reason.
And now that we have this option, I have seen this, uh, uh, um, change in the behavior that once they start losing weight on this molecule. Their, uh, adherence to the lifestyle modification improves a lot because this weight loss with these molecules, they kind of give them the new hope that for so many years, my, I couldn't lose my weight, but now I'm seeing the change in my weight and I would like to, you know, uh, try my best to maintain this weight loss.
And hence, they are more likely to stick to the diet and exercise regimen, all of that.
Kudrat (Host): Obesity and diabetes are a serious problem in India, and it’s only going to get worse. According to a PubMed study, by 2040, 30-31% Indian men will be overweight, and 27% of Indian women. And, obesity will rise to ~9.5% for men and ~13.9% for women.
This is a public health problem.
That’s where modern medicine steps in. Drugs like semaglutide offer a kind of breakthrough—especially for people who’ve tried everything else and still struggled. For many patients, these aren’t shortcuts. They’re lifelines. A way to take control of their health when traditional advice—eat less, move more—simply hasn’t worked.
But this shift also raises bigger questions. As GLP-1 drugs become more affordable through generics, who gets access first? Will these become routine tools for managing chronic illness—or luxury lifestyle enhancers for those who don’t need them?
Kudrat (Host): That's all for today. You just heard The Signal Daily. We don't do hot takes. Instead, we bring you deep dives into the how and why of consumer trends. The Core produces The Signal Daily. Follow us wherever you get your favourite podcasts.
To check out the rest of our work, go to www.thecore.in.
If you have feedback, we'd love to hear from you. Write to us at feedback at thecore.in or you can write to me personally at kudrat at thecore.in.
Thank you for listening.
