Mumbai, India – For 49-year-old television producer Mukta Dhond, a monthly ritual has become a stark symbol of her transformative journey. "I have to take my 20 pairs of jeans to the tailor for size alterations," she shares, a hint of pride in her voice. This isn’t a mere fashion update; it’s a tangible testament to a life reshaped by the burgeoning influence of GLP-1 receptor agonists, a class of drugs that are rapidly becoming a global phenomenon, and are now making significant inroads into India’s complex health landscape.
Dhond’s story is emblematic of millions worldwide grappling with obesity and its metabolic consequences. A single mother who has long battled her weight, a pivotal moment occurred during a 2024 vacation in Scotland. While her toddler son effortlessly scaled the inclines, Dhond found herself gasping for breath, a stark realization that spurred her into action. At the time, she was pre-diabetic. "He would run up the hills and I would be far behind. I realized it was time to change things," she recalls. Her journey with Ozempic, a prominent GLP-1 drug, began in March 2025. Weighing 117 kg then, she now stands at 95 kg, describing the experience as a profound "reinvention and liberation – a game-changer."
The Global Surge and India’s Cautious Embrace
The impact of GLP-1 drugs is not confined to individual success stories. A report by UBS Investment Bank forecasts that by 2029, there will be approximately 40 million global users of these medications. Dhond’s experience resonates with countless individuals whose metabolic health and self-esteem have been eroded by the cumulative effects of obesity. According to Dr. Alexandra Sowa, a New York-based obesity expert and author of "The Ozempic Revolution" (2025), Dhond embodies the ideal GLP-1 user. Sowa emphasizes that thriving on these medications requires more than just the drug; it demands a holistic approach to eating, thinking, living, and fundamentally, a redefined relationship with food.
In India, a nation often dubbed the "diabetes capital of the world," the rise of obesity is a parallel epidemic, creating a dual burden of malnutrition and overweight individuals. While these drugs offer a beacon of hope, their integration into the Indian healthcare system is marked by a blend of cautious optimism and pragmatic concerns.
A Transformative Journey: From Struggle to Sustained Health
Dhond’s current fitness regimen is a far cry from her previous struggles. It includes swimming, strength training three times a week, short walks after every meal, monthly blood work, and bi-monthly endocrinologist follow-ups. This comprehensive approach comes at a monthly cost of up to ₹20,000. The GLP-1 injections themselves are priced between ₹8,000-₹10,000 per dose, with generics now available for ₹3,500-₹4,500. Despite the price reduction with generics, Dr. V. Mohan, a Chennai-based diabetologist and chairman of the Madras Diabetes Research Foundation, notes that "they are still beyond the reach of the common man."
Dhond’s weight loss trajectory accelerated when her prescription was switched to Mounjaro after six months. Her Body Mass Index (BMI), which stood at 45 at the start of her GLP-1 journey (normal range up to 23), significantly improved. While chronic pains vanished and blood parameters normalized, she experienced a concerning drop in thyroid levels and "unreal" muscle loss and sagging. It was through sustained adherence to fitness and a meticulously crafted diet – rich in lean proteins, healthy fats like olive oil and avocado, and minimal carbohydrates – that her thyroid levels and muscle health began to recover. This highlights a critical caveat: GLP-1s can exacerbate muscle loss, a significant concern given India’s existing protein deficiency crisis. Doctors are increasingly emphasizing the importance of small, protein-rich meals throughout the day for GLP-1 users.
Bollywood filmmaker Hansal Mehta’s experience echoes Dhond’s. Three years ago, at 105 kg, he had tried various diets and exercise regimes with limited success. For the past eight months, on Mounjaro, coupled with rigorous strength training and cardio four times a week, intermittent fasting, and a cocktail of supplements, Mehta has shed 32 kg, now weighing 73 kg. "My actual age is 57, but based on all health parameters, my metabolic age is 43," he proudly states. His long-standing high blood pressure has stabilized. Mehta, however, cautions against attributing his success solely to the medication: "At parties, my weight-loss journey often gets dismissed as ‘Oh, he is on Mounjaro.’ But the reality is I am doing so much more than just the pill."
Conversely, a lack of comprehensive lifestyle modification protocols can lead to disappointing outcomes. A 33-year-old Bengaluru-based finance professional, who wished to remain anonymous, shared his and his wife’s experience with Mounjaro. While they initially lost 10 kg over four months due to drastically reduced food intake, they suffered from constant low energy, mood swings, and nausea. "Mounjaro definitely doesn’t live up to its hype," he lamented, adding that his wife regained 4 kg soon after discontinuing the drug.
Dr. Mohan, who actively uses social media to demystify these drugs, frequently addresses questions about their duration and side effects. He advises prospective users to be prepared for potentially lifelong treatment and reassures them that common side effects like nausea usually resolve, while more severe ones like pancreatitis and thyroid cancer are rare. However, he reiterates, "GLP-1s are still not the solution for diabetes and obesity crises in our country."
The Science of Satiety: Understanding GLP-1 Receptor Agonists
Glucagon-like peptide-1 (GLP-1) receptor agonists, approved in the U.S. for weight loss in 2021, are synthetic versions of a natural gut hormone. GLP-1 plays a crucial role in regulating blood sugar by stimulating insulin release, reducing glucagon secretion, and most importantly, inducing feelings of satiety or fullness. This mechanism of action is the core of their efficacy in managing type-2 diabetes and obesity.
In the context of GLP-1 use, "food noise" has emerged as a new term, referring to the constant mental chatter surrounding hunger and eating. These drugs aim to completely silence this noise in individuals struggling with obesity and diabetes. However, the concept of "food noise" in India takes on a different dimension. For millions facing food insecurity, the battle is not about resisting cravings but about accessing sufficient nutrition. India grapples with a paradoxical epidemic: while 172 million Indians are undernourished according to the 2025 SOFI report, the National Family Health Survey-5 (2019-21) reveals that approximately 24% of women and 23% of men are overweight or obese.
Dr. David Chandy, director of endocrinology and diabetology at Sir H.N. Reliance Foundation Hospital, Mumbai, acknowledges the excitement surrounding these drugs. "Newer agents in this family, and dual incretin drugs such as tirzepatide, have changed the conversation because, for the first time, we have medicines that can produce meaningful and, sometimes, dramatic weight reduction," he states. The American Diabetes Association’s updated guidelines now place weight management at the forefront of diabetes care, with GLP-1 based therapy being a preferred approach when significant weight loss is a primary goal.
The Generics Boom and Shifting Market Dynamics
The GLP-1 market in India is nascent, with pharmaceutical company representatives informally estimating its current value at around ₹100 crore. A significant development occurred in March this year with the expiry of Novo Nordisk’s patent for Semaglutide, the most widely used GLP-1 drug. This has triggered a surge in generic versions entering the market. Sun Pharmaceutical, for instance, has launched Sematrinity and Noveltreat, priced between ₹2,690 and ₹7,490, depending on the dosage. A spokesperson for Sun Pharmaceutical stated, "We are working closely with government institutes and trying to make the generics available widely." In a move that intensifies competition, Novo Nordisk has reportedly slashed the prices of Ozempic and Wegovy in India by 36% and 48% respectively.
The Indian Paradox: Genetics, Culture, and Metabolism
India’s food culture is deeply intertwined with community, tradition, and lineage. GLP-1 drugs, by largely rendering users "food-proof," can profoundly alter social interactions and personal habits. Dhond, who was once a "party girl," now finds her social life centered more around fitness activities and genuine connection rather than food and drink. Mehta echoes this sentiment, noting that "that one glass of wine is a rarity now."
However, the biological underpinnings of obesity and diabetes in India present a unique challenge. Unlike in many Western nations where obesity is primarily a metabolic crisis, in India, it is often a complex interplay of genetic predispositions, foetal undernourishment, increasing consumption of processed foods, and a societal resistance to regular exercise.
Dr. Ravi Sankar Erukulapati, senior consultant endocrinologist at Apollo Hospitals, Hyderabad, highlights the prevalence of "sarcopenic obesity" – a condition characterized by low muscle mass and high fat mass, which exacerbates insulin resistance. He also points to a general lack of awareness, where many equate the absence of visible obesity with good health, a notion that often proves false in the Indian context.
Dr. Dheeraj Kapoor, head of endocrinology at Kokilaben Dhirubhai Ambani Hospital, Mumbai, cautions against viewing these drugs as a panacea for the nation’s health challenges. "These drugs are not a quick-fix at a population level. Access, cost, and appropriate use will determine impact. Even in the best-case scenario, it will take years before we see a meaningful shift in overall numbers."
The "Thin-Fat Indian" Phenomenon
The "thin-fat Indian" body type, characterized by thin limbs and a disproportionately large abdominal fat distribution, is a well-documented phenomenon. This profile, often seen in individuals over 40, is particularly resistant to conventional weight-loss strategies. GLP-1s, while effective in reducing overall body fat, can rapidly diminish muscle mass – a concern amplified in individuals already predisposed to sarcopenia. Dhond’s experience with Mounjaro, which she describes as "death by muscle loss," underscored the necessity of integrating a comprehensive lifestyle and exercise protocol.
Dr. Chittaranjan Yajnik, who coined the term "thin-fat Indian" in the early 2000s, discovered in the 1980s that his own glucose-insulin metabolism was poorer than that of his heavier English colleagues, despite his slender build. "Indians deposit most fat in and around the abdomen. The highest glucose levels are in those who have low BMI but high waist measurement," he explains. His research suggests that genetic and epigenetic factors, including in-utero exposure to challenging environments, increase the risk of future diabetes, obesity, and heart disease. Dr. Ramesh Hariharan, CEO and co-founder of Strand Life Sciences, notes that the heritability of obesity in India is estimated at 40%-70%, influencing behaviors around hunger, satiety, and food reward. He emphasizes, "Genetics loads the gun, lifestyle pulls the trigger." While obesity-related genes cannot be modified, lifestyle remains the most potent tool for managing the condition.
Backlash, Regulation, and an Uncertain Future
The rapid approval and widespread promotion of GLP-1s in India have not been without controversy. A Public Interest Litigation (PIL) was filed in the Delhi High Court in May 2025 by Jitendra Chouksey, a fitness evangelist and founder of FITTR, challenging the unbridled use of these drugs, particularly in wellness clinics. "I felt it was needed because of the fast approvals these drugs got, and the way it is being used not just in hospitals, but in wellness clinics," Chouksey stated, citing concerns about dangerous muscle mass loss and rapid weight regain upon cessation.
In response, the Indian government issued guidelines in early April, mandating prescriptions from endocrinologists, cardiologists, or internal medicine specialists for both original and generic GLP-1 drugs. Marketing efforts encouraging unsupervised use have also been strictly prohibited.
The allure of rapid weight loss has even extended to aesthetic treatments. Klarity Health Clinic in Delhi offers a "Mounjaro Bride Package" for ₹1.10 lakh for 12 sessions, indicating a growing trend of GLP-1 use for cosmetic purposes.
While GLP-1s are showing promise beyond weight and metabolism, impacting conditions like addictions, menopausal health, autoimmune diseases, and even mental health in the U.S., their long-term effects on human metabolism and the human body remain a subject of ongoing research. In the Indian context, with its unique genetic makeup, cultural nuances, and dual epidemics of malnutrition and obesity, the promise of these drugs is significant but conditional. The GLP-1 revolution has arrived, but its ultimate impact on humanity’s quest for optimal health on an overburdened planet remains to be seen.
