In closed groups and online forums, users compare dosages, swap sourcing tips and even discuss methods of storing low-cost vials.

Offline, they walk into clinics asking for the same drug by name.

“I want GLP-1.” Or, “which is better... Ozempic or Mounjaro?”

Times have changed from when people had an “injection-phobia and preferred oral medications,” says senior endocrinologist Dr V Kumaravel. “People are now outrightly asking for these drugs by name,” adds Madurai-based Kumaravel, with the Endocrine Society of Tamil Nadu.

This is despite caution from the Union Health Ministry and doctors that GLP-1 drugs - including semaglutide or tirzepatide – are breakthrough products, but they come with side-effects, and should not be used indiscriminately. (Semaglutide is the active ingredient in Danish company Novo Nordisk’s obesity drug Wegovy and diabetes drug Ozempic; and Tirzepatide is sold by American company Eli Lilly as obesity drug Mounjaro.)

There has been a burst of generic versions of semaglutide, since late March, after the patent on it expired – paving the way for local drugmakers to launch their versions at lower prices. And they did - over 25 generic brands in vials, reusable pens and oral tablets were launched at prices 50 to 80 percent lower than the original products (Ozempic, Wegovy, Rybelsus). From between ₹10,000 to ₹17,000, the monthly costs dropped to ₹1,290 (the lowest price point is being offered by Natco Pharma)

Lilly’s , however, is still under patent with costs between ₹15,000–₹20,000, but continues to top this category.

The worrying side of the weightloss story, though, is that demand for GLP-1 drugs is being shaped outside traditional medical settings, warn doctors.

“Most people come after seeing Instagram, or after hearing from someone else who has taken it,” Dr Kumaravel said. “They come with a fixed agenda of getting one of the GLP-1 drugs. We evaluate whether it is suitable,” he said, adding that the number of people asking for the drug is “multiple times higher” than those who are eventually prescribed it.

This trend is amplified by gyms, “wellness clinics” and thrive with online and offline peer recommendations, another physician in a tier-2 city said.

Meanwhile, in social media and online discussion platforms, users seek advice on sourcing drugs, adjusting doses, comparing managing side effects, using injection pens, and diet choices—discussions that should be held with doctors.

There are before and after shots taken at homes, recording of progress, demonstrating the efficacy of the drug, and some even seek-out prescribers willing to supply the drug—or bypass prescriptions altogether – an investigation by the correspondent found.

Obesity, not cosmetic weight loss

Before GLP-1 drugs, doctors say, there were limited medical options for obesity. “There was no drug that could help you lose weight. Doctors advised diet and exercise, but patients were coming because those were not working for them. In that gap, many unregulated remedies came up, none of them evidence-based. When GLP drugs came in, they entered with strong efficacy,” Dr Kumaravel explained.

In India, the drug can be prescribed only by endocrinologists, internal medicine specialists and cardiologists. It is prescribed to people with a BMI of 25 or above with metabolic risk factors or co-morbidities, say doctors. Obesity is defined by a BMI greater than or equal to 25 kg/m².

A Mumbai-based GLP- 1 user (who did not want to be named) says: “I got really tired of working hard and still not losing weight… Then I came across how much GLP-1s helped people, especially with PCOS (Poly Cystic Ovarian Syndrome). There are a lot of side effects, so I was hesitant. But I’ve been living with a different set of side effects anyway. So I decided to pick my struggle.”

Side effects do feature on the online discussion platforms. GLP-1 drugs are known to cause nausea, vomiting, bloating, diarrhoea, constipation, tachycardia, dizziness, among others.

But this hasn’t halted new users. As one GLP-1 drugsuser said, “Even with all the awful side effects like insomnia, sulphur burps and constant diarrhoea, if this is the kind of progress I’m getting, I’ll take it anyday.”

Global health authorities also caution on possible serious side-effects like vision loss, kidney failure, thyroid cancer. “One of the earlier reported side effects of semaglutide was causing sudden blindness.. called as non-arteritic anterior ischemic optic neuropathy. With mass usage, people have forgotten about this,” Dr Kumaravel said.

Doctors also cautioned that rapid weight loss can lead to muscle loss if not monitored. “When you lose weight, it is not only fat—you lose muscle as well,” said Dr Kumaravel. “If this is done under medical supervision, we monitor and support it. Though it’s a wonder molecule, I’m completely against off-label use. It’s a double-edged sword.”

Even with the success stories, where users reach their target weight, they reported renewed cravings and weight gain once the drug is discontinued.

Jitendra Chouksey, Founder-CEO of health platform FITTR, says, GLP-1s were never meant to replace a healthy lifestyle. “If these drugs were truly helping, wouldn’t we’ve seen a reduction of obesity prevalence globally?” he asked, since these drugs have been in the market for sometime. “Instead, what we are seeing is short-term impact with low long-term adherence... and increasing obesity prevalence worldwide without a pause”

He also cautioned on heart-related affects after discontinuation. “A recent study also showed degradation to cardiac health is much faster once a user stops the drugs compared to before, to upto 22% in 18 months,” he says, adding that the absence of sustained benefits—often referred to as a “legacy effect”—raises questions about long-term dependence.

“As long as people are seeing quick benefits, long-term side effects won’t be realised till it’s too late.. just like junk-food or alcohol or tobacco,” he said. “This is already too late in some ways, because access has expanded beyond tightly controlled medical settings,” he observed.

Dr Kumaravel is concerned: “It (the decision) has now moved from a doctor’s place to a consumer market.” And while “government can control the doctor market...controlling consumers or mob behaviour is much harder.”

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Published on April 20, 2026