'Weight loss drugs can be life changing but are not without risks,' says Dr Vishnu Radhakrishnan as he explains the truth behind Ozempic and Mounjaro.
In the last two years, drugs like Ozempic, Wegovy, Mounjaro and Zepbound have jumped from the medical world straight into pop culture.
Influencers talk about them, reels dissect them and people are ordering them without prescriptions because of their dramatic weight loss results.
Rishika Shah/Rediff spoke to Dr Vishnu Radhakrishnan, senior consultant endocrinologist, diabetologist and medical director at CataLife Health Care, Kerala.
Dr Radhakrishnan (MD, DNB, MRCP UK, DM -- AIIMS Delhi) calls these drugs "helpful and a boon" but only when prescribed responsibly.
They help reverse diabetes and fatty liver, improve PCOS, increase fertility, reduce long-term disease risk and produce significant, medically meaningful weight loss.
But they are not shortcuts, not beauty treatments, and definitely not DIY drugs.
He explained exactly what these drugs do, who they are meant for and why unsupervised use can be dangerous.
IMAGE: Dr Vishnu Radhakrishnan Photograph: Kind courtesy Dr Vishnu RadhakrishnanWhat exactly are these drugs?
Ozempic (semaglutide), Mounjaro (tirzepatide) and similar injections fall under a newer class of medications originally created for diabetes.
They mimic natural gut hormones, GLP-1 and GIP, which regulate appetite, digestion and insulin.
In simple terms, they reduce appetite, slow down the emptying of the stomach, improve insulin sensitivity, reduce fat storage, help the body burn more fat and aid weight loss while generally sparing muscle.
Mounjaro is considered more advanced because it acts on two hormones (GLP-1 + GIP) while Ozempic acts on one.
Are Mounjaro and Ozempic only for diabetics?
No. US FDA and global endocrine societies now approve them for obesity treatment too.
Ideal candidates should have a BMI of over 30 or over 27 with obesity-related issues like diabetes, prediabetes, hypertension, PCOS, osteoarthritis, sleep apnea and fatty liver.
Indian cut-offs are even lower because Indian bodies store more visceral fat. Here, it is BMI 27 without diseases and BMI 25 with obesity-related complications.
They can also be used in certain normal BMI individuals who have non-alcoholic fatty liver disease, which is surprisingly common even in lean people.
Who should not take these drugs?
There are clear contradictions:
- Personal/family history of medullary thyroid cancer
- Pregnant or breastfeeding women
- History of pancreatitis
- Severe diabetic gastroparesis
- People combining them with certain diabetes or epilepsy medications because the risk becomes higher.
If you are a smoker, you need to stop smoking before taking the drug.
If you consume alcohol, then you need to reduce your intake to 3-4 pegs a week for men and 2-3 pegs a week for women.
Can they be used for beauty purposes?
These drugs are not meant for cosmetic weight loss. They are powerful medical tools with serious effects and should only be used at a certain weight threshold.
But their misuse is rampant in India. Certain gyms and non-specialists are freely giving them out. Counterfeit versions are being sold as well.
Is medical supervision needed with these drugs?
Absolutely!
Because dosage, step-up schedules and side-effect monitoring matter.
Before you start using these drugs, you need to do tests such as thyroid function test, your blood count, liver function test, lipid profile and an ultrasound or fibroscan for fatty liver.
These tests help assess risk and track improvement.
What are the common side effects?
The common side effects include nausea, vomiting, diarrhoea and bloating.
Usually, these occur only when the dose is started or increased.
What are the red flag side effects?
Red flag side effects include severe abdominal pain radiating to the back, persistent vomiting, signs of pancreatitis and severe gastric intolerance.
These occur in less than one per cent of patients, but must be treated urgently.
As far social media concerns about depression and suicidal thoughts as side effects are concerned, it is not evidence-based.
Depression claims are being exaggerated online. Obesity itself is a far bigger killer.
Will you lose muscle?
All weight loss involves some muscle loss but GLP-1 drugs are generally muscle sparing.
I would suggest having 1 gram of protein per kg of body weight daily, regular resistance training and avoiding extreme diets like keto.
Newer drugs, especially tirzepatide (Mounjaro), show preferential fat loss over muscle loss in trials.
How long should someone stay on these drugs?
Realistically, obesity medications are meant to be long term, even lifelong.
But many of my patients use them for one to one-and-a-half years, lose significant weight, improve their fitness level and then maintain weight through lifestyle changes.
However, your appetite will return after stopping so discipline become crucial.
Does everyone regain weight after stopping?
Not everyone but it's common.
We have three eating patterns: Hedonic eating (pleasure driven), homeostatic eating (hunger driven) and executive control (carefully deciding what to eat).
GLP-1 drugs reduce the first two. After stopping, the cravings return so, without strong conscious control, weight gain in likely.
Still, for people who have 'tried everything', these drugs life-saving, especially when it comes to diabetes reversal, fatty liver reversal, PCOS correction and improved fertility in men and women.
Many women with PCOS have conceived after this treatment (though the drug must be stopped 2-3 months before pregnancy).
How much weight do people actually lose?
With Mounjaro, one can end up losing 20-25 per cent of their body weight in 1.5 years (some lose even more).
With Ozempic, one can typically lose 10 to 15 per cent of their body weight.
Overall, 95 per cent of patients lose at least five to 10 per cent of their body weight at minimum.
In order to reverse diabetes and PCOS, one needs to at least lose 15 per cent of one's body weight which usually isn't always achievable organically for every individual.
What is the cost of this treatment in India?
The cost differs from drug to drug.
- Liraglutide (daily injections): Costs Rs 2,000 to Rs 6,000 per month
- Ozempic (weekly injections): Starts with Rs 6,000 and can go up to Rs 10,000 per month
- Mounjaro (most expensive but the most effective; it's a weekly injection): Costs Rs 13,500 to Rs 26,000 per month
What kind of impact do reels and influencers have when it comes to the increasing popularity of these drugs?
Influencers are misguiding people. Information is coming from the most unqualified source. Some reels highlight rare side effects and ignore the fact that obesity itself causes cancers, diabetes and early death.
Gyms are procuring or selling these injections. There are fake products in the market. Non-specialists are prescribing these hormones.
Hormonal injections are not for gyms. Take protein or creatine, not these.
© 2026