New weight-loss and diabetes drugs: Are they truly game-changers? | Second Opinion

India is facing a growing twin epidemic of Type 2 diabetes and obesity, fuelled by sedentary lifestyles and calorie-dense diets. With over 100 million people living with diabetes, a new class of injectable medicines is reshaping how metabolic diseases are treated across the country.

Drugs such as Ozempic, Mounjaro and Wegovy have attracted attention for their ability to rapidly lower blood sugar levels and induce significant weight loss. However, medical experts caution that these medicines are not “magic pills” and must be used carefully, under supervision, and alongside lifestyle changes.

In Second Opinion, doctors explain what these drugs can deliver, their limitations, and what Indian patients must know before considering them.

Growing burden

Urban India has witnessed a sharp rise in obesity, which is closely linked to increasing diabetes rates. In response, injectable drugs that act on gut hormones have emerged as powerful tools in diabetes and obesity management.

In December 2025, Novo Nordisk launched Ozempic in India at a price of around Rs 2,200 per week. Approved for managing blood sugar in Type 2 diabetes, clinical trials show it can also result in 13–15 per cent body weight loss, along with cardiovascular and kidney benefits.

Eli Lilly’s Mounjaro, launched in March 2025, has shown even stronger outcomes, with average weight loss of 20–22 per cent and superior blood sugar control, though at a higher cost.

Wegovy is approved specifically for obesity treatment, while Ozempic remains approved only for diabetes. Other available options include Rybelsus, an oral formulation, Trulicity, and older injectables such as Victoza, all offering varying degrees of effectiveness.

How they work

These medicines are transforming metabolic care, but doctors stress that they come with side effects and practical challenges. Nausea, vomiting and gastrointestinal discomfort are common, particularly when treatment begins.

Senior diabetologist Dr V Mohan explained why Mounjaro has shown greater weight-loss effects. “As far as Mounjaro is concerned, tirzepatide is a dual agent working on both GLP and GIP. The effects in reducing blood glucose as well as weight reduction are actually more than semaglutide,” he said.

He noted that Ozempic and Wegovy have been in use internationally for nearly a decade, which is why semaglutide has stronger long-term evidence so far.

Clinical evidence

Dr Mohan highlighted that semaglutide has demonstrated strong cardiovascular and kidney protection. “If you look at the cardiovascular outcome trials, semaglutide has very robust clinical outcomes in reducing heart attacks and has also been shown to be beneficial for the kidneys,” he said.

Mounjaro, he added, is still accumulating evidence for these additional benefits. “Both molecules are equally good. It is left to the physician and the patient to decide which molecule to take.”

A potential shift could occur in March 2026, when semaglutide patents are expected to expire, opening the door for lower-cost generics and wider access in India. Until then, doctors caution that these drugs are best suited for selected patients, under strict medical supervision, and used alongside lifestyle modifications.

Lifestyle still key

Dr Aafrin Shabbir, internal medicine and diabetology consultant at Gleneagles Hospital, stressed that lifestyle measures remain central, even when patients are on these drugs. “Lifestyle plays a major role, with or without these drugs. Regular exercise and a healthy diet are vital,” she said.

She pointed out that gastrointestinal side effects such as acidity and gastritis are common and can be managed with dietary changes. “Patients need to eat small, frequent meals every two hours, stay hydrated, and include fruits, fibre and vegetables in their diet,” she said, adding that many patients tend to drink less water because they feel full, which can lead to dehydration, headaches and muscle cramps.

Dr Shabbir also emphasised the importance of adequate protein intake. “A high-protein diet helps prevent muscle loss and ensures that most of the weight loss comes from fat,” she said. Good sleep, hydration and regular meals, she noted, significantly improve tolerance and outcomes with these medications.

Not a magic pill

Doctors consistently warn against unrealistic expectations. Side effects are common, which is why treatment must start with very low doses and be increased gradually.

“We have to start with very low doses and build it up over weeks, whether it is semaglutide or tirzepatide,” Dr Mohan said. “This helps patients tolerate the medication better.” He also cautioned that these drugs only work while they are being taken.

“These drugs work only as long as you take them. If you stop, the weight generally comes back,” he said, adding that patients must be prepared for long-term treatment.

Response to the drugs varies widely. Some patients lose weight rapidly, others see moderate benefits, and a small group may see little improvement in either weight or blood sugar levels.

Studies show that stopping treatment often leads to weight regain and worsening diabetes control within a year to a year and a half, reinforcing the need for sustained use.

Informed choices

As India battles rising diabetes and obesity, these drugs offer new possibilities, but informed use is critical. Doctors advise patients to discuss their goals, risks and long-term plans with a diabetologist or physician before starting treatment.

Ozempic, Wegovy or Mounjaro may not be magic pills, but with proper medical guidance and lifestyle discipline, they can be effective tools in managing diabetes and obesity.

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