From Reddit to the clinic: The hope, hype and weight loss behind Mounjaro, Wegovy in India

Two weeks ago, she shared a side-by-side photo of herself in a pink gym T-shirt, one month apart — the same pose, the same mirror, the same woman, only lighter. The caption read: “One month on 7.5 mg of Mounjaro — down 6 kg and feeling the shift.”

Her post gathered 371 upvotes — not a single downvote.

After her first few injections of Mounjaro, her body felt lighter, but her mind grew curiously heavy. “I was emotionally flat,” she recalls. “I didn’t want to talk to anyone. I would just stay in my room. I didn’t feel like myself.”

On Reddit, she wrote: “My motivation, mood and even basic joy levels feel… flat.”

Her two posts — one of triumph, one of quiet despair — now sit side by side on her profile, perfectly capturing the duality of the Mounjaro moment. Her story mirrors what’s unfolding across the country — a wave of excitement, confusion and introspection around a new generation of weight-loss drugs that have entered Indian markets in 2025.

While India’s top drug regulator, the Central Drugs Standard Control Organisation, approved Eli Lilly’s Mounjaro (with tirzepatide as active ingredient) for both type-2 diabetes and weight management earlier this year, Novo Nordisk’s Wegovy (semaglutide) was launched in India in June 2025 specifically for obesity. Besides, Novo Nordisk’s Ozempic (semaglutide injection) and Rybelsus (oral semaglutide), have shown weight loss effects in global clinical trials, though in India, they have been approved only as diabetes drugs. Together, these medications belong to a new class known as GLP-1/GIP receptor agonists, which mimic natural hormones that help regulate blood sugar, appetite, and digestion — key factors in weight control.

In a country with rising obesity levels and spending capacities, at least among the urban middle- and upper-income groups, the drugs have been eagerly received, even by doctors, who view it as a breakthrough class of drugs in obesity care. Just six months after the launch of Mounjaro in India, it has already become one of the country’s top-selling medicines — not by volume, but by value — second only to GSK’s antibiotic Augmentin, according to market estimates. Market intelligence and analytics firm Pharmarack estimates that Mounjaro recorded sales worth Rs 80 crore in September, while Augmentin had 85 crore.

Behind these numbers lies a more complicated story. Zoom out, and you see billion-dollar products, their sales powered as much by the marketing muscle of pharmaceutical giants as by human hope. Online spaces are now fertile ground for drugmakers, where influencer tie-ins promise “effortless change” in just a few sittings. But zoom in, and the picture shifts: these blockbuster drugs are no magic pills, but stories of individuals, each fighting their own battles. Just like Shyamla.

Not magic pills?

These drugs have earned their blockbuster status on the back of strong science, with evidence showing benefits that go far beyond blood sugar control.

For instance, Novo Nordisk’s Ozempic was first approved in 2017 by the US Food and Drug Administration (FDA) for type-2 diabetes, with later approvals for heart (2020) and kidney protection (2025) after major studies proved its broader impact. Its Wegovy, a higher-dose version, followed in 2021 for weight management, with clinical trials showing that patients lost an average of 15% of their weight. In 2024, it was approved for heart protection in people with obesity. Mounjaro arrived in the US in 2022 for diabetes, demonstrating powerful effects on both glucose and weight. Its counterpart, Zepbound, was cleared in 2023 for weight loss (up to 22% weight loss) and in 2024, for treating obstructive sleep apnea in adults with obesity.

So is this class of drugs a turning point in metabolic medicine?

“Metabolic medicine is a very big word,” says Dr Nikhil Tandon, one of India’s foremost endocrinologists, and head of the Department of Endocrinology and Metabolism at AIIMS, New Delhi.

He explains that the drugs may indeed mark a turning point, but insists that the claim must be understood in context.

Acknowledging that these drugs appear to show benefits related to lower weight and blood sugar, Dr Tandon says, “Obviously, I am not trivialising weight reduction — it becomes important as it improves quality of life. And if you have people with diabetes, you need glucose reduction. But overall, the most important outcome is mortality reduction. Most specifically, since cardiovascular mortality will be the largest component within people with obesity and diabetes, the real test of these drugs will be if they reduce heart-related deaths and events. We really need to analyse the numbers from that perspective. And data is emerging that there are benefits on all scores.”

He agrees that the entry of these drugs does mark a turning point for GLP-1 and metabolic medicines. “All prior oral or injectable therapies (for diabetes) did not focus on weight so much. They were not really studied in detail for harder clinical outcomes. Now, because of the necessity of looking at cardiovascular outcomes for all diabetes-related medicines as mandated by the FDA and EMA (EU’s drug regulatory body), we have data on that.”

‘Thin-fat’ obesity

Yet, calling them blockbuster drugs may be premature, at least in an Indian context.

Obesity in India looks different from the West. People have leaner bodies, but higher visceral fat — that is, they may have a “normal” BMI but carry dangerous fat around the organs, a pattern that health experts call “thin-fat” obesity. That makes the health risks — diabetes, heart disease — deceptively high.

So are Indian patients responding differently from Western trial populations?

“I have actually asked this question to the main companies who are leading this (clinical trials). I haven’t really got granular data to that effect… I’m sure they have that data, but it is not in the public domain. They have not yet shared it with us,” Dr Tandon says. “But it is a very important question. Because the sort of obesity we have in India is very different. Therefore, one has to be very clear.”

He recalls that when GLP-1 receptor agonists were used earlier on some of his diabetic patients, they reacted negatively to the weight-loss effect — interpreting it as “weakness” rather than a health benefit. “In fact, when we tried GLP-1RA initially as a glucagon-lowering agent, there was weight loss with that. Some of the patients were not very happy. They were not significantly overweight when they started, because diabetics in India need not always be overweight. But there was a perception that the patient has become very weak.”

But will India’s obesity and diabetes care landscape truly change in the next five years because of these drugs? Dr Tandon pauses before answering, “There will be an impact.”

Then comes the caveat. “Remember, they are expensive drugs. If semaglutide goes off patent, you might see more people take it. We will find out. It is always dangerous to make forecasts. In terms of therapeutic agents, these drugs will make an impact, but the quantum of impact will depend on how many can afford them.”

For instance, Mounjaro is priced at Rs 3,500 for the 2.5 mg dose and Rs 4,375 for the 5 mg dose (or Rs 14,000 and Rs 17,500 per month, depending on the dosage). In comparison, Wegovy is priced higher, with its lower-dose variants — 0.25 mg, 0.5 mg, and 1 mg — costing around Rs 17,345 monthly, while the 1.7 mg and 2.4 mg doses are priced at Rs 24,280 and Rs 26,015 per month, respectively. These injectables are administered once a week.

At AIIMS, which straddles both patient care and research, the next phase of GLP-1 work will dig deeper — to find out how these drugs work on those with cardiovascular and fatty liver diseases, beyond weight management.

But Dr Tandon says the practical questions are just as important: “Do we continue once the target weight is reached? Can we down-titrate the dose, or give periodic drug holidays so patients aren’t exposed continuously? Those are the kinds of questions we’ll need to answer.”

Adjusting doses and learning patience

Meanwhile, Shyamla is still listening to her body — adjusting doses, managing side effects, learning patience. She understands the journey isn’t a sprint, rather a marathon.

It all began after a fall in 2017. “It was just a minor fracture. Nothing alarming, but my physical activity reduced drastically,” she says.

By the following year, her body felt unfamiliar — heavy — and the weighing scale needle tilted alarmingly. She joined fitness groups, tried structured meal plans, counted every calorie and pushed herself to stay consistent – even turned down an endocrinologist’s recommendation for bariatric surgery — but the weight wouldn’t budge.

By 2022, her weight had gone up to 158 kg. “I was eating only 1,800 calories a day, exactly what my new endocrinologist suggested. Still, no change,” she says.

The answer finally came after years: a pituitary adenoma, a benign tumour sitting silently in her pituitary gland, the tiny control centre for hormones. It had been overproducing certain hormones, throwing her metabolism into chaos.

In March 2023, she was put on Rybelsus. The Novo Nordisk oral semaglutide, launched in India in 2022, is designed to improve blood sugar control in people with type-2 diabetes, but her doctor prescribed it to her off-label.

“I took it for almost two years and lost about 8 kg. But I’d gain it back. It was a constant see-saw,” she says.

By then, social media was buzzing with stories about miracle weight-loss injections. Many Indians were ordering them from abroad. “Honestly, I couldn’t afford it. But my doctor advised me to wait. He said Mounjaro would soon be available in India. He told me, ‘Don’t buy anything online. It could be fake’.” she says.

Finally, in March, when Mounjaro was launched, she was among the first to be prescribed the drug. “Usually, people start at 2.5 mg. Since I’d already been on Rybelsus, my doctor started me at 5 mg,” she says.

For years, her mind had been a battleground — cravings, guilt, the endless hum of wanting. “Suddenly, I didn’t feel like eating. I felt at peace for the first time in years,” she says.

But her body had its own story to tell. “I started feeling bloated — not pain, just a constant unease. So I began taking antacids thrice a week, just to feel normal,” she says.

She feared muscle loss. “I started strength training thrice a week, swimming on other days. I fixed my protein, added fibre. The bloating eased a little.”

Then came the loneliness. “At 5 mg, I locked myself in my room. I’m an artist, but for months I couldn’t touch a brush. I felt emotionally flat.”

Now, on 7.5 mg, she feels flickers of hope. “It’s a little better,” she admits.

Still, every morning brings the same quiet battle. “In my head, I’m still 158 kg. Even though I’m 132 kg now, the mirror doesn’t show me that,” she says. “It’s hard to believe the change.”

Two weeks ago, she caught her reflection in the gym mirror. “My waist looked a little defined. I compared it to a photo from February. I realised it’s happening — slowly, but surely. I felt so happy I posted about it.”

Her biggest lesson is sobering. “This drug isn’t magic. What people post online — it’s not always real or sustainable. You need patience, discipline and a doctor who understands your body. Once, a woman, 22, messaged me on Reddit, asking where to buy the drug. I told her to talk to a doctor first.”

Then there’s the cost. “We’re burning money. It’s not covered by insurance. Every month, you feel the pinch,” she says.

Still, she hesitates to stop. “Now my brain isn’t ready to accept a lower dose. By mistake, I took a higher dose — 15 mg. For three days, there was no hunger. I felt brilliant, at the peak of my energy levels. My fitness band usually shows 160–180 calories during normal swimming sessions, but those days it showed 320. That was the level of energy I gained. I’ve scheduled an appointment to talk about it. Is this my magic dose? I don’t know,” she says.

As Dr Tandon points out, the conversation around these drugs is just beginning. Beyond their headline-grabbing benefits, there are still important real-world questions to answer — from how best to dose them to understanding their broader clinical effects over time. As far as India is concerned, as he emphasises, it is still too early to judge long-term trends, and the real impact on the obesity curve will depend largely on affordability and access.