After the semaglutide molecule, used to treat type 2 diabetes and/or weight loss, went off patent last Friday, a flood of branded generics entered the market. The reaction has ranged from euphoria to alarm, as these generic versions are selling at 50-80 per cent lower than the price for the hitherto patented brands, Ozempic and Wegovy. In other words, the monthly cost of these generics is set to drop from ₹12,000 to ₹3,000 or below, making it accessible not just to middle-class, middle-aged, obese diabetics, but also to younger people who want to ‘look good’. The drug is helpful in treating obese diabetics. Its possible misuse by the fitness industry is a huge concern.
Practitioners and users should know how semaglutide works, and what its side-effects are. Semaglutide, which belongs to a class of medicines called GLP-1 receptor agonists, engineers the brain to curb hunger, stimulates insulin release when blood sugar levels are high, and slows down digestion. There is no denying its effectiveness in reducing weight loss over a few months, and in curbing sugar levels. It is recommended for those with a body mass index of above 30 kg per sq m, or 27 kg per sq m with a medical condition. Such individuals need to shed weight quickly to reduce the risk of a stroke, or heart attack. The drug is essentially administered as a weekly injectible (2.4 mg dosage). Semaglutide is, however, not recommended for those with a family history of thyroid cancer. In rare cases, it could lead to blindness. It is not to be used by those who are not medically obese, and that includes diabetics.
Using semaglutide to shed weight is a real worry. But that has been happening the world over – and could break out as a trend in India as well. According to the fifth edition of the National Family Health Survey (2019-21) quarter of India’s population between 30-49 years is ‘abdominally obese’, with a BMI of above 25. Meanwhile, 10 per cent of the population is estimated to be diabetic. The obese population is a captive market; it stands to reason that semaglutide be administered for diabetes alone. Yet, it has been actively branded and marketed as a weight loss drug worldwide, with celebrities engaged in surrogate advertising and the fitness industry selling it surreptitiously as a health food. Semaglutide brands have raked in over $60 billion over the years. The government needs to watch the sales closely. Earlier this month, it has rightly advised against surrogate advertising and misleading campaigns.
It is just as well that only an endocrinologist can prescribe semaglutide. However, the best way to regulate the misuse of semaglutide is retail it selectively, as with psychiatric medication. The contraindications should be prominently spelt out, and its branding as a weight loss drug disallowed. Finally, the medical community and government need to reiterate that obesity and diabetes are lifestyle disorders, and can be treated with normal medication and some everyday discipline.
Published on March 26, 2026