India embraces cheaper weight loss drugs but doctors are worried

Pankhuri Pareek is one of an increasing number of Indian women prescribed Mounjaro to lose weight. (Supplied: Pankhuri Pareek) Several pharmaceutical companies have begun selling cheaper, generic brands of semaglutide weight loss drugs in India after the patent expired in March. More people are turning to weight loss medication in the country that has the world's second highest number of overweight adults. Health professionals are calling for stricter regulation over concerns about misuse. Link copiedShareShare articlePankhuri Pareek wanted to return to a fit and healthy lifestyle after having her baby daughter but struggled to lose her pregnancy weight. "I even gained a lot of weight, more than the pregnancy itself," Ms Pareek told the ABC. She said despite diet changes and trying to exercise more, she found she was experiencing "energy crashes", her blood sugar levels were dropping and she could not stop craving food. She was told her weight gain was partially linked to her polycystic ovarian syndrome (PCOS). Draft international guidelines on polycystic ovary syndrome (PCOS) highlight how weight stigma — being judged or discriminated against because of our weight — can prevent women from getting the proper treatment and support they deserve. Women with PCOS are more prone to gaining weight due to high levels of insulin while excess androgens can change weight distribution. They also find it more difficult to shed the kilograms due to a reduced Basal Metabolic Rate, meaning they burn fewer calories while resting. Ms Pareek was prescribed Mounjaro, an injectable medication containing tirzepatide that reduces appetite and is used for managing type 2 diabetes and weight loss. Tirzepatide is a different active ingredient to semaglutide, which is used in Ozempic. "Everything started getting normal; I feel better as a human being, I feel fitter," she said. Pankhuri Pareek said she started using Mounjaro earlier this year after undergoing thorough medical assessments. (Supplied: Pankhuri Pareek) Ms Pareek said more people were starting to open up and share their experiences of taking weight loss drugs in India. "A lot of the time people read blogs and people start communicating on Instagram that they're doing other brands," she said. "It's easy to get influenced in seconds but that's not the right thing because it could cause side effects." Ms Pareek said she took IV drips to keep her nutrients and hydration up and increased her strength training to prevent muscle loss, which can be a side effect of Mounjaro. Other common side effects of Mounjaro include nausea, vomiting, diarrhoea and constipation, while some of the more serious ones include pancreatitis, severe dehydration, hyperglycemia and gallbladder issues, according to the Australian Commission on Safety and Quality in Healthcare. Mounjaro has become one of the top selling drugs in India, a country with the world's second-highest number of overweight adults and more than 77 million people with Type 2 diabetes, according to The Lancet medical journal. When the key patent on semaglutide, the active ingredient in drugs like Ozempic and Wegovy, expired in India this year, several Indian pharmaceutical companies moved to launch lower-cost generic versions, opening up new competition in a fast growing market for obesity treatment. To sell a generic version of an approved drug in India, companies are generally required to demonstrate that their medicine performs similarly to the original by submitting bioequivalence and bioavailability data to the Central Drugs Standard Control Organisation. Ozempic-style medications have been recommended as long-term treatments for obesity under new guidelines released by the World Health Organization. While the patent for Mounjaro has not yet expired in India, the increased competition with generic semaglutide drugs hitting the market has seen prices slashed across the sector. Ozempic and Wegovy now sell for as little as $20 in India for a low dose, according to its company Novo Nordisk India. With generic brands priced up to 70 per cent less than that, making the treatment significantly more affordable. That demand is expected to grow further, with India's market for weight loss drugs projected to be worth 80 billion rupees ($1.18 billion) before the end of this decade, according to Indian research firm, Pharmarack. But Indian health professionals have warned of growing misuse of weight loss drugs, cautioning that wider availability of cheaper, generic brands could put patients' health at risk if not regulated properly. Doctor Preethi Mrinalini, a laparoscopic and bariatric surgeon in Chennai, who herself takes Mounjaro said she did not recommend the new generic brands of weight loss drugs to her patients because she felt there was not enough "adequate research or trial by data". She added that she now receives daily enquiries about weight loss drugs, including from people who are not even overwei

India embraces cheaper weight loss drugs but doctors are worried

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