Semaglutide generics may fuel rush for cosmetic weight loss, warn doctors

As semaglutide goes off patent, doctors warn of misuse by non-obese individuals amid rising demand driven by social media and lower-cost generics

As semaglutide, the blockbuster obesity and diabetes drug, goes off-patent in India, clearing the way for a wave of lower-cost generics, doctors across the country are reporting a sharp rise in patient inquiries. These are coming not only from people with diabetes or chronic obesity, but also from otherwise healthy individuals seeking weight loss.

 

Clinicians say the expected price drop has significantly broadened interest in the therapy, a trend further amplified by social media buzz and influencer-led promotion.

 

“There are clear clinical criteria for prescribing this drug, and it is not meant for cosmetic weight loss,” said Rajiv Kovil, a senior Mumbai-based diabetologist. He noted that patients without diabetes must meet defined body mass index thresholds and also have obesity-related conditions to qualify. He added that treating it as a “weight-loss shortcut” would trivialise its wider role as a disease-modifying therapy with benefits for cardiovascular, liver and metabolic health. 

Doctors say they are increasingly having to turn away patients who do not medically qualify for the drug. Aparna Govil Bhasker, a consultant bariatric and laparoscopic surgeon from Mumbai, said her practice had seen a rise in queries from people already within a healthy weight range but wanting to lose more. “This is not something you pick up after seeing it on Instagram or hearing a celebrity talk about it. It has specific indications and potential side effects, some of them serious,” she said. She warned that unsupervised use could lead to adverse outcomes and unpredictable long-term effects. 

Beyond physical risks, the trend also reflects deeper psychological concerns, caution medical experts. The growing demand from individuals aiming for extreme or medically unhealthy weight targets points to body image issues that often go unaddressed. “Why would someone want to become underweight? That itself signals an underlying problem,” Bhasker noted.

 

The concern is compounded by easy access and weak enforcement. Although the therapy is prescription-based, doctors warn that patients might still find ways to obtain it without adequate supervision. “When affordability grows, access expands beyond the intended patient pool, increasing the risk of misuse,” Kovil said. He stressed the need for tighter regulation, including prescriptions that clearly stated the medical indication and strict adherence to dosage controls.

 

Experts also flagged the risk of supply distortion, where rising off-label demand could potentially limit availability for patients genuinely in need of the therapy. At the same time, inappropriate dosing, often driven by misinformation online, could lead to complications ranging from gastrointestinal issues to more serious conditions like gallbladder disease or metabolic disturbances.

 

Meanwhile, the broader market is expected to expand significantly with the entry of generics. Sukhvinder Singh Saggu, a New Delhi-based bariatric surgeon, said increased affordability would improve access for eligible patients and likely drive higher prescription rates among physicians. However, he stressed that treatment decisions would continue to hinge on efficacy, safety, and clinical need, even as price competition intensified.

 

With regulators already moving to curb direct advertising of GLP-1 therapies, doctors say the responsibility now lies across the ecosystem — from physicians and pharmacists to patients and drugmakers — to ensure responsible use. As interest surges, clinicians underscore a clear message: This is a prescription therapy for specific medical conditions, not a quick fix for cosmetic weight loss.