The calls come thick and fast to Mumbai-based diabetologist Rahul Baxi - but not just from patients struggling to control blood sugar.
Increasingly, it is young professionals asking the same thing: Doctor, can you start me on weight-loss drugs?.
Recently, a 23-year-old man came in, worried about the 10kg he'd gained after starting a demanding corporate job. One of my gym friends is on [weight loss] jabs, he said.
Dr Baxi says he refused, asking him what he would do after losing 10kg on the drug.
Stop, and the weight comes back. Keep going, and without exercise you'll start losing muscle instead. These medicines aren't a substitute for a proper diet or lifestyle change, he told him.
Such conversations are becoming increasingly common as demand for weight-loss drugs explodes in urban India - a country with the world's second-largest number of overweight adults and more than 77 million people with Type 2 diabetes.
Originally developed to treat diabetes, these drugs are now being hailed as game changers for weight loss, offering results that few previous treatments could match. Yet their growing popularity has also raised difficult questions - about the need for medical supervision, the risks of misuse and the blurred line between treatment and lifestyle enhancement.
These are the most powerful weight-loss drugs we've ever seen. Many such drugs have come and gone, but nothing compares to these, says Anoop Misra, who heads Delhi's Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology.
Two new drugs dominate India's fast-growing weight-loss market: semaglutide and tirzepatide, both part of the GLP-1 drug class that helps regulate appetite. They make people feel fuller faster and curb cravings, with injections taken weekly.
Doctors warn that most users can regain weight within a year of stopping and that prolonged use without exercise can strip away muscle. Side effects range from nausea to more serious complications, highlighting the importance of medical guidance. India's high-carb, low-protein diet also raises concerns about long-term weight loss strategies.
The anti-obesity drug market has seen a staggering growth from $16m in 2021 to nearly $100m today, driven by an increasing acceptance of obesity as a chronic disease rather than a lifestyle issue. As generics become available, the accessibility and potential for misuse of these drugs will be critical discussions moving forward.
