The drug was first approved for the treatment of diabetes in 2017 by the US Food and Drug Administration. However, it soon gained popularity for the significant weight loss it led to, with physicians prescribing it off-label to patients struggling with obesity. In 2021, the FDA officially approved Wegovy — a higher-dose version of semaglutide — as treatment for chronic weight management. While semaglutide — and its successor tirzepatide — took the world by storm, both entered the Indian market only in 2025. The Indian Express spoke to endocrinologists, Dr Shashank Joshi of Lilavati Hospital, Mumbai, and Dr AG Unnikrishnan of Pune’s Chellaram Diabetes Institute.
Patients are concerned about continuing the drug indefinitely. Can the dosage be tapered down?
Dr Unnikrishnan: Diabetes and obesity are chronic conditions for which people need to continue taking the medicine till the benefits last — people already do that for conditions such as diabetes, cholesterol and hypertension. There are some clinicians who are reducing doses in their patients but that can be done on a case-to-case basis. The protocol cannot be generalised for all. Also the drug must be used in tandem with diet and exercise.
Why the need for caution?
Dr Joshi: This class of drugs, GLP-1 RA, which mimic the functioning of gut hormones, need to be carefully administered in Indians because we have the “thin-fat” phenotype, which means we have visceral fat inside muscle, liver and epicardial tissue while weighing normal. Such people run the risk of significant lean muscle mass loss as a proportion of total weight lost. This can adversely affect the muscle-to-fat ratio and potentially lead to frailty or functional deterioration, especially in older adults. So treatments should only be taken under medical supervision and strictly according to prescribed dosage. Microdosing is not recommended.
Abdominal obesity in Indians means they are at a higher risk of metabolic diseases. How does the drug impact people with high abdominal obesity?
Dr Joshi: What we have seen so far — with the oral drug for four years and now the weight-loss dose for nearly six months — is that Indians tend to lose more weight than the global average. Sometimes even with the lowest dose we see weight loss of up to 20 per cent of the body weight.
What about side effects?
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Dr Unnikrishnan: Side effects in India are so far similar to the data in published medical science literature.
Dr Joshi: Vigilance is the key. The drugs must be taken under strict supervision. Common side effects like nausea, vomitting, diarrhoea and constipation can be minimised by grading doses. Rare side effects on pancreas or other organs are under scrutiny.
Is there a concern that there could be an overuse or misuse of the drugs?
Dr Unnikrishnan: There are two sides to this — there are people living with diabetes and obesity who do not want to take the medicine because of side-effects and others who want it for cosmetic reasons. People should go to the right doctor and get a prescription.
Dr Joshi: The medicine should not be prescribed by dieticians.
Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues .
Professional Background
Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature.
Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO.
Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives.
Awards and Recognition
Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.”
Recent Notable Articles (Late 2025)
1. Cancer & Specialized Medical Care
"Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease.
Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose.
2. Environmental Health (The "Breathless Pune" Series)
Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs.
"For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune.
3. Lifestyle & Wellness News
"They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions.
At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents.
4. Scientific Recognition & Infrastructure
For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics.
Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far.
Signature Beat: Health, Science & Women in Leadership
Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions.
... Read More
Anonna Dutt is a Principal Correspondent who writes primarily on health at the Indian Express. She reports on myriad topics ranging from the growing burden of non-communicable diseases such as diabetes and hypertension to the problems with pervasive infectious conditions. She reported on the government’s management of the Covid-19 pandemic and closely followed the vaccination programme.
Her stories have resulted in the city government investing in high-end tests for the poor and acknowledging errors in their official reports.
Dutt also takes a keen interest in the country’s space programme and has written on key missions like Chandrayaan 2 and 3, Aditya L1, and Gaganyaan.
She was among the first batch of eleven media fellows with RBM Partnership to End Malaria. She was also selected to participate in the short-term programme on early childhood reporting at Columbia University’s Dart Centre. Dutt has a Bachelor’s Degree from the Symbiosis Institute of Media and Communication, Pune and a PG Diploma from the Asian College of Journalism, Chennai. She started her reporting career with the Hindustan Times.
When not at work, she tries to appease the Duolingo owl with her French skills and sometimes takes to the dance floor. ... Read More
There are some clinicians who are reducing doses in their patients but it can be done on a case-to-case basis; cannot be generalised for all
