A family reunion is in full swing. A young girl looks at old photo frames on a wall and wonders how two elderly relatives, who looked well-rounded in their young years, are in perfect shape now. As she admires their transformation and asks for a group photo, she asks the photographer to capture her from a distance so that her plus size “fits in the frame.” That’s when the elderly women tell her that obesity is not about shame, self-deprecation or a lack of will, it is a chronic disease which is treatable if she visits a doctor.
The elderly aunts are played by actors Ratna Pathak Shah and her sister Supriya Pathak in Eli Lilly India’s awareness campaign to reduce the stigma around obesity. But while the campaign is intended as a lesson in health science and seeks to find answers to India’s burden of chronic illnesses, obesity being a risk factor, it begets the criticism if it is also not in some way a surrogate promotion of Eli Lilly’s GLP-1-based weight loss drug in the market, Mounjaro. This is a once-weekly, subcutaneous injection approved for improving blood sugar control with spinoff weight loss benefits and mimics two gut hormones, GLP-1 and GIP.
Novo Nordisk’s injectable Wegovy is meant for weight loss and mimics GLP-1. In fact, Anjali Chopra, 42, who has been battling body weight issues was quite taken in by Novo Nordisk’s ad “wegowithyou”, which phonetically plugs Wegovy, and its smart use of the 10,000 step fitness mantra: “At 9,999 steps on your weight loss journey? Now, also take 1 step towards your doctor.” She asked her doctor if she needed weight loss drugs even before she had got tested for diabetes or attempted a serious fitness routine. Now with weight-loss generics pegging down prices and shiny ads showing people leading vivacious lives, she doesn’t want to be left behind.
And therein lies the problem. From advertisements to fitness brands launching GLP-1-aided weight-loss programmes and influencers talking about their journey with the drug on social media, the last few months have been a marketing push towards their adoption in India. Experts feel this would entrench the magic jab formula and negate the other important part of weight management — diet, exercise and a non-negotiable lifestyle discipline. In fact, the drug’s effects can only hold with these props, they add.
The marketing push
The big hoardings, newspaper and television advertisements, and social media posts have largely come from the innovator companies of the two popular GLP-1 drugs available in India. But none of them has named the drug or its brand. And that is the legal loophole.
A former drug regulator, on condition of anonymity, says that the Drug and Magic Remedies Objectionable Advertisements) Act actually has a provision that prohibits marketing of drugs for certain listed conditions. “Action can be initiated by the regulator for any advertisement of these drugs,” he adds. This list consists of at least 54 such medical conditions, including common conditions like diabetes, hypertension, cancer, tuberculosis and obesity. Yet, no action can be taken in these instances as the drug is not mentioned. That’s why they can pass off as an awareness campaign of certain conditions.
“There was a case in the 90s against GSK when they had put out advertisements announcing the takeover of the popular brand of fever medicine Crocin from Durphar Interferan. But the companies have since become smarter — the provisions cannot be applied if the medicine name or brand is not mentioned,” the regulator says.
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Even in cases where the action can be initiated, it’s just a slap on the wrist. “The companies are let off with a small penalty. This does not deter them. Smaller companies selling Ayurvedic drugs and sexual remedies continue to flout the norm because it is not stringent enough,” the regulator explains.
These strategies led to the country’s drug controller, the Central Drugs Standard Control Organisation (CDSCO), issuing an advisory. Its statement reads: “Certain pharmaceutical companies may be engaging in direct or indirect (surrogate) promotional activities, including disease awareness campaigns, digital media outreach and other communications relating to GLP-1 receptor agonists and similar prescription drugs indicated for obesity and metabolic disorders…. Any promotional activity, including so called awareness campaigns, that function as surrogate advertisement for prescription-only drugs shall be viewed seriously and may be treated as irrational or misleading marketing practice.”
Other than direct marketing, there is also a push that is coming from weight-loss programmes. Social media feeds have been flooded with “doctor-led” programmes that promise to help people lose weight with the GLP-1 drugs. These programmes are being offered by well-known fitness brands such as Cult-fit. Non-medical personnel, too, are offering these drugs. This despite the drug regulator clarifying in no uncertain terms that the drug should be provided to patients only on prescription of an endocrinologist, diabetologist, internal medicine specialist or cardiologist in some cases. “There is a huge demand for these drugs and in some places in Delhi, stores and pharmacists are selling them without the prescription. Vigilance is a challenge when there is fierce competition. Usually, medical stores are located in clusters of four or five and if one person refuses sales on demand, the rivals end up offering them. Even when a store asks for a prescription, it may be an AI-generated one too. Who is checking,” asks the owner of a large Delhi-based pharmaceutical store.
Dr V Mohan, Chairman, Dr Mohan’s Diabetes Specialist Centre, says that there have been reports of gym instructors and dieticians using the medicine. “It must be ensured that the drug is dispensed only with a prescription and must not be used in weight loss programmes by non-physicians. These are very powerful drugs that act on the brain and the stomach. These are meant for cases of morbid obesity, where the person has more than one risk factor compromised by body fat. Side-effects, while mild in most cases, can also sometimes be severe like pancreatitis, thyroid cancer, paralysis of the stomach and blindness in a few cases,” he says.
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The sales push
When it comes to the generic brands, a huge push for pickups is coming from stockists. One of them admits that all the companies, which launched their products earlier this month between Rs 1,300 to Rs 7,000 a month, had been aggressively pushing the injectables to retailers. “These have to be stored at 2-8 degree celsius. If an inventory is created, the pharmacies will try to sell it — it is difficult to store these drugs for long periods,” he says.
Another stockist says the companies have not offered any discounts or credits to retailers. “These are products that have already been paid for by us and they are unlikely to be taken back. So, they are pushed down the chain and have to go out,” he says.
A market expert, citing an example, says, “One of the companies that has launched the product now says that it has already done primary sales of Rs 2 crore but products worth only say Rs 60 lakh have reached the retailers. This means the market is stocking up.”
The easy availability of the medicine online — with doctor consultation on call — is also a challenge for the regulators.
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A question of trust
Dr Anoop Misra, Chairman, Fortis C-Doc for Diabetes and Allied Sciences, says he had been using the innovator molecule for a year before he became comfortable with it. “It will take some time for us to trust the new brands, see their efficacy. Even now, a few years after dapagliflozin went off patent, I usually prescribe the innovator molecule and just a couple of generic ones in some cases.”
Multiple studies have shown that ads influence prescription rates. Sometimes, such campaigns may drown out the possibility of existing, cheaper drugs working as effectively. “Besides efficacy varies from person to person. That’s why there is need for abundant caution,” adds Dr Misra
However, there is a silver lining. A store owner says that with so much information about weight loss drugs available online, there was already a built-in market when innovator drugs were launched in 2025. “Now, these campaigns may have just spread the idea that they are accessible to many who genuinely need it.”
