GLP1-RA and Weight Loss Growth in India – Tendencies, Considerations and Warning – Dr. Amit Bhargava, Dr. Varsha Narayanan

Summary

Glucagon-like peptide-1 receptor agonist (GLP1-RA) semaglutide and tirzepatide have gotten generally prescribed medicines for weight reduction with even semaglutide generics now accessible in India. With the increase in weight reduction brokers’ market, it is very important be cautious of dangers concerned and keep away from indiscriminate use. Weight loss program and life-style modification ought to all the time be the primary method and individualised prescribing selections after thorough analysis of affected person fitment and dangers, together with common and meticulous monitoring for opposed results is pertinent for these medicine. Prepared availability of those medicine with out prescriptions or medical consultations in pharmacies and on-line platforms wants curbing. Launch of OTC oral GLP1-RA as well being complement with out printed medical knowledge or sufficient security analysis is very regarding.

Key phrases: GLP1-RA, Weight loss program, Vitamin, Bodily coaching, Weight reduction, Weight problems, Semaglutide, Tirzepatide, Korglutide

Introduction

Our editorial in November 2025, mentioned Glucagon-like peptide-1 receptor agonist (GLP1-RA) medicine semaglutide and tirzepatide intimately, utilized in each kind 2 diabetes and weight administration, mimicking the physique’s pure GLP1 hormone. In India, amongst GLP1-RA for weight reduction, as on 2025 there have been primarily 2 authorized branded innovator medicine as injections at excessive worth: Semaglutide (Wegovy) and Tirzepatide (Mounjaro), a twin GLP1 and GIP receptor agonist. Nevertheless, with patent expiry for semaglutide in 2026, plenty of generics have entered the fray. Anticipating the identical, the innovator manufacturers themselves diminished costs considerably, making these injections way more accessible to most of the people. World Weight problems Day is noticed on March 4^th and that is an apt time to deal with this weight reduction market increase and related considerations.

The mechanism of motion of those medicine includes enhancing glucose-dependent insulin secretion from the pancreas, slowing gastric emptying, lowering urge for food, rising satiety, lowering meals cravings and lowering glucagon launch, all contributing to weigh loss.^1,2  For weight reduction, the authorized GLP1-RAs are indicated for adults who’ve weight problems (physique mass index [BMI] of 30 kg/m² or larger) or are obese (BMI of 27 kg/m² or larger) with no less than one weight-related well being situation like hypertension, kind 2 diabetes, excessive ldl cholesterol or obstructive sleep apnea. These medicine might help lose 5-10% of physique weight or extra, over a 12 months and might also assist decrease the danger of main opposed cardiovascular occasions (MACE), Acute MI, stroke or cardiovascular-related loss of life), continual kidney illness (CKD) together with weight reduction.^3,4

Presently there isn’t any oral GLP1-RA authorized in India for weight reduction. As of early 2026 in India, Semaglutide (Rybelsus), an oral GLP-1RA is authorized just for managing kind 2 diabetes. Nevertheless, its potential for off-label or indiscriminate use for weight reduction in non-diabetics wants vigilance and warning. Moreover, Korglutide, a GLP1 and IGF1-RA has been concerningly authorized for the Indian market as an oral purposeful meals complement for weight reduction with none peer-reviewed proof.

Prescribing Choice Considerations

Research have proven weight reduction between 13-20% over 12-18 months with semaglutide and tirzepatide.^5,6 Monitoring opposed results and potential dangers are essential. They embody (a) GI side-effects (commonest), (b) renal dysfunction, (c) limiting use in sufferers with extreme gastroparesis and/or historical past of pancreatitis and/or gallbladder illness, (d) danger elements for colorectal most cancers. Common ophthalmic retina screening, vigilance for muscle loss (sarcopenia) and psychiatric results are additionally obligatory.

Subsequently, there are clearly dangers concerned and these 2 medicines mustn’t grow to be indiscriminate first line weight-loss brokers as a ‘one measurement matches all’ measure.⁷ That is the largest concern perceived with this market increase, that anybody desirous to drop extra pounds will entry these brokers. Individualised prescribing selections after thorough analysis of affected person fitment by authorized indication, dangers, life-style and weight-reduction plan ought to all the time be the way in which to associate with common and meticulous monitoring for opposed results. Prepared availability of those medicine with out prescriptions or medical consultations in pharmacies and on-line platforms typically marketed as miracle weight-loss options needs to be strictly curbed and stopped. Indiscriminate use will result in larger occurrences of side-effects and their publicity amongst patient-groups & public, resulting in real sufferers shunning these medicines.⁸ For these with out diabetes or not having excessive BMI and comorbidities, who nonetheless need to drop extra pounds for private or skilled causes, life-style modification with supervised wholesome diets and bodily train are all the time essentially the most applicable. For these sufferers who qualify for a GLP1-RA based mostly on authorized indications, the next priorities have to be included of their administration⁹:

• Affected person-centred initiation with weight reduction/ well being objectives.
• Baseline screening together with (a) common dietary habits, (b) emotional triggers, (c) cravings and (d) all related related medical circumstances.
• Complete examination together with (a) muscle power, (b) muscle perform and (c) physique composition evaluation.
• Life-style evaluation together with (a) cardio exercise, (b) power coaching, (c) sleep, (d) psychological stress, (c) substance use, (d) social join and (e) well being determinants.

Throughout GLP-1 use, other than strict monitoring and vigilance for opposed results as talked about, dietary counselling, stopping nutrient deficiencies, preserving muscle and bone mass by resistance coaching with weight-reduction plan and connecting to assist teams and digital platforms are additionally essential to enhance compliance in addition to long-term weight upkeep post-cessation.

The function of train is usually underplayed and direct comparisons reveal that although GLP-1RAs usually produce larger short-term weight reduction than train alone, train is superior for sustaining lean mass and cardiorespiratory health and lowering danger of heart problems and atherosclerosis.¹⁰ Physique weight and physique composition are maintained one 12 months after termination of supervised train, in distinction to weight regain after termination of remedy with weight problems pharmacotherapy alone.¹¹ Weight administration ought to prioritise built-in approaches that mix pharmacotherapy with life-style interventions and workout routines relatively than changing life-style adjustments with treatment alone.

New OTC Agent Elevating Concern

Korglutide, (firm – Cargen, South Korea) a GLP1 and IGF1 RA has entered the Indian market as a purposeful meals complement for weight reduction, supposed to be bought as an over-the-counter (OTC) oral product as a powder (mixing the contents of 1 sachet with approximate 100mL water and consumed at any time of day, with or with out meals).¹² A 12-week medical trial performed in India with 100 members, although registered on CTRI, has not been peer-reviewed & printed wherever with the outcomes solely reported in information releases and trade media.¹³  The pharmaceutical trade has raised considerations over the research, its claims and knowledge and approval of korglutide¹⁴:

• The corporate famous that the outcomes have been solely “partially disclosed” and has not introduced plans for formal publication in a peer-reviewed worldwide journal.
• In weight problems drug medical trials, excessive accuracy dual-energy X-ray absorptiometry (DEXA) is employed to reinforce the accuracy of physique composition evaluation and variations in density of fats, muscle and bone. Alternatively, korglutide research used bioelectrical impedance evaluation (BIA) gear, much like physique fats measurement units generally seen in gyms, that may generate errors based mostly on hydration ranges or meals, resulting in limitations in accuracy.
• The design of the research additionally raises considerations, because the pattern measurement is just 100 sufferers and the research is 12 weeks, relatively than 6 months, 1 12 months or past as seen with the authorized GLP1-RA medicine. Subsequently, long-term efficacy upkeep, plateauing or discount of results has not been evaluated nor has weight acquire studied after stopping korglutide.
• There may be lack of sufficient and long-term security knowledge which is a vital level for a GLP1-RA. Actually, no opposed results knowledge has been printed wherever. Compliance points or withdrawal on account of gastrointestinal or different unwanted side effects has additionally not been addressed.
• For weight reduction results >5% drug approval is beneficial however nonetheless korglutide is authorized as a well being purposeful meals with the corporate stating that the regulatory limitations for well being purposeful meals are decrease than for prescription drugs, making market entry simpler. This “quick-to-market” method by by-passing a inflexible scientific overview makes one surprise on the intent of the corporate’s Indian companion in addition to on the molecule itself.
• Moreover, it claims that whilst a well being purposeful meals, korglutide has increased efficacy and security than current weight problems medicine, making it aggressive but when that’s certainly the declare, it shouldn’t be categorised as a well being purposeful meals.
• The underside line unequivocally stays that no drug or complement will be granted approval with out sufficient research and their publication in peer-reviewed journals of great reputation.

Conclusion

The burden loss market of India is booming and GLP1-RA semaglutide and tirzepatide have gotten generally prescribed medicines for weight reduction with even semaglutide generics now accessible in India. Nevertheless, it is very important be cautious of dangers concerned and prescribe these medicine solely of their authorized indication. Weight loss program and life-style modification ought to all the time be the primary and concomitant method. Prescribing selections needs to be patient-specific after thorough analysis of fitment, historical past, medical evaluation and dangers, together with common and meticulous monitoring for opposed results. Availability of those medicine with out prescriptions or medical consultations in pharmacies and on-line platforms wants pressing curbing. Launch of OTC oral GLP1-RA as well being complement with out printed medical knowledge or sufficient security analysis is very regarding and this must be collectively addressed by the well being authorities and medical skilled organisations. Even with the information, long-term real-world research have clearly proven that critical opposed occasions can happen and subsequently as of now, it isn’t applicable for any GLP1-RA needs to be an OTC or have complement standing.

References

1. Zheng, Z., Zong, Y., Ma, Y. et al.Glucagon-like peptide-1 receptor: mechanisms and advances in remedy. Sig Transduct Goal Ther 2024; 9, 234.
2. Li H, Yu G, Huang Q, Yang B, Nie J, Liu Y, Tu X. Efficacy and security of GLP-1RAs for individuals with weight problems: A scientific overview based mostly on RCT and Bayesian community meta-analysis. Biomed Pharmacother. 2024 Feb;171:116150.
3. Jensterle M, Rizzo M, Haluzík M, Janež A. Efficacy of GLP-1 RA Authorized for Weight Administration in Sufferers With or With out Diabetes: A Narrative Overview. Adv Ther. 2022 Jun;39(6):2452-2467.
4. Rivera FB, Cruz LLA, Magalong JV, Ruyeras JMMJ, Aparece JP, Bantayan NRB, Lara-Breitinger Ok, Gulati M. Cardiovascular and renal outcomes of glucagon-like peptide 1 receptor agonists amongst sufferers with and with out kind 2 diabetes mellitus: A meta-analysis of randomized placebo-controlled trials. Am J Prev Cardiol. 2024 Might 7;18:100679.
5. Aronne LJ, Horn DB, le Roux CW, Ho W, Falcon BL, Gomez Valderas E, et al. SURMOUNT-5 Trial Investigators. Tirzepatide as In contrast with Semaglutide for the Therapy of Weight problems. N Engl J Med. 2025 Jul 3;393(1):26-36
6. Rodriguez PJ, Goodwin Cartwright BM, Gratzl S, et al. Semaglutide vs Tirzepatide for Weight Loss in Adults with Obese or Weight problems. JAMA Intern Med.2024;184(9):1056–1064.
7. Ghusn W, Hurtado MD. Glucagon-like Receptor-1 agonists for weight problems: Weight reduction outcomes, tolerability, unwanted side effects, and dangers. Obes Pillars. 2024 Aug 31;12:100127.
8. Mittal A. India’s GLP-1 Growth: Tread with warning. India At this time [online]. 17^th February 2026. Obtainable from https://www.indiatoday.in/well being/story/indias-glp-1-boom-tread-with-caution-2869033-2026-02-16
9. Mozaffarian D, Agarwal M, Aggarwal M, Alexander L, Apovian CM, Bindlish S, et al. Dietary priorities to assist GLP-1 remedy for weight problems: A joint Advisory from the American School of Life-style Medication, the American Society for Vitamin, the Weight problems Medication Affiliation, and The Weight problems Society. Weight problems (Silver Spring). 2025 Aug;33(8):1475-1503
10. Codella R, Senesi P, Luzi L. GLP-1 agonists and train: the way forward for life-style prioritization. Entrance Clin Diabetes Healthc. 2025 Nov 24;6:1720794
11. Jensen SBK, Blond MB, Sandsdal RM, Olsen LM, Juhl CR, Lundgren JR, et al. Wholesome weight reduction upkeep with train, GLP-1 receptor agonist, or each mixed adopted by one 12 months with out remedy: a post-treatment evaluation of a randomised placebo-controlled trial. EClinicalMedicine. 2024 Feb 19;69:102475.
12. Mun-hee C. Caregen Completes Registration of GLP-1 Peptide ‘Korglutide’ in India. Enterprise Korea [Online]. July 30^th, 2025. Obtainable from https://www.businesskorea.co.kr/information/articleView.html?idxno=248443
13. WHO-Worldwide Scientific Trials Registry Platform. Scientific Research of Korglutide in Weight Administration in Overweight People With and With out Kind 2 Diabetes. April 7^th, 2025. Obtainable from https://trialsearch.who.int/Trial2.aspx?TrialID=CTRI/2025/01/078994
14. Hyun-a Y. Caregen claims Korglutide surpasses Wegovy in weight reduction effectiveness. Chosun Biz EN [Online]. July 31^st, 2025. Obtainable from https://biz.chosun.com/en/en-science/2025/07/29/VGTXK3RNHFGH7FO3H4GYDXE3UQ/

¹Medical Affairs Marketing consultant and Household Doctor, Holistic Proof-based Recommendation, Analysis and Therapy (H.E.A.R.T), Mumbai

Corresponding creator: ²Chief Editor, The Indian Practitioner and Medical Director, Dr Varsha’s Well being Options, Mumbai. Electronic mail: [email protected]