Something interesting is happening in urban India. At high-end gyms, members are openly discussing their “Mounjaro progress.” Corporate health plans are fielding requests to cover these medications. Players in the QSR (Quick Service Restaurants) industry are evaluating the impact on their bottom line.
The trigger?
A class of drugs called GLP-1 receptor agonists—medications like Ozempic, Wegovy, and Mounjaro that were initially developed for diabetes but have turned into the most disruptive force in weight management globally.
GLP-1 drugs have crossed over from niche diabetes medication to mainstream conversation.
Last month, Eli Lilly’s Mounjaro became India’s top-selling drug by value. Mounjaro generated INR 1 billion through sales just in October. Around the same time, Novo Nordisk slashed prices on Wegovy by 37% to capture the Indian market.
According to a 2024 survey in the US by Bernstein, over one-third of GLP-1 drug users eat a lot less junk food. About 43% order small portions, and about 39% skip out on indulgent desserts afterwards.
What’s happening here goes far beyond healthcare. We’re witnessing the early innings of a transformation that will ripple through pharma, food delivery, QSR chains, fitness, insurance, and even how we think about personal productivity.
Let’s understand what this means for wealth creators.
In this edition, we’ll explore:
- How GLP-1 drugs are causing seismic shifts globally
- How India’s obesity epidemic makes this a massive opportunity
- The business impact: from pharma to QSRs, fitness to insurance
- Investment implications across sectors
- What this means for India’s health future
Let’s begin.
The science behind the hype: What are GLP-1 drugs?
GLP-1 (Glucagon-Like Peptide-1) receptor agonists work by mimicking a hormone your body naturally produces after eating. They do three critical things:
- Suppress appetite by signaling fullness to the brain
- Slow gastric emptying, keeping you satisfied longer
- Improve insulin sensitivity, helping manage blood sugar
Originally developed for Type 2 diabetes, these drugs showed a remarkable side effect: significant weight loss. Not the modest 2-3% you’d see with traditional diet pills, but 15-20% of body weight in clinical trials.
That changed everything.
In the US, where Novo Nordisk’s Wegovy launched in 2021, demand exploded so fast the company couldn’t keep up. By 2024, GLP-1 drugs were generating over $40 billion annually globally. Novo Nordisk briefly became Europe’s most valuable company, surpassing LVMH and the entire GDP of Denmark.
Now that phenomenon is landing in India and the timing couldn’t be more critical.
India’s obesity crisis: The silent epidemic
Here’s a statistic that should concern every wealth creator: India has 101 million people with diabetes and 254 million people with generalized obesity, according to a 2021 study by the Indian Council of Medical Research (ICMR). These numbers have marginally increased since then.
But the real story is about the velocity of change.
India’s obesity prevalence:
In 2015-16 the prevalence of overweight/obesity among urban men and women was around 48.7% and 49.7% respectively.
Recent reports indicate that the prevalence of overweight/obesity among urban adults is already very high, with some sources stating over 70% of the urban adult population is overweight or obese.
Projections for obesity alone in urban areas by 2040 are around 11.4% for men and 19.7% for women (using standard BMI cutoffs).
While these numbers are scary, the economic cost is equally staggering.
According to the Global Obesity Observatory, obesity cost India approximately ₹ 2.4 lakh crore) in 2019. This burden is expected to surge to ₹ 6.7 lakh crore by 2030.
The India entry: Pricing, access, and market dynamics
When Novo Nordisk launched Wegovy in the US, it was priced at approximately $1,300 per month (₹1.08 lakh). In Europe, government negotiations brought it down to around €250-400 per month (₹23,000-37,000).
In India, the initial launch pricing for Wegovy was around ₹50,000 per month. The price gradually reduced over time and then in November, Novo Nordisk slashed prices by 37%. The company recognised that at ₹50,000/month, they were pricing out the vast middle class that represents India’s largest growth opportunity.
Eli Lilly’s Mounjaro has been even more aggressive. Within months of launch, Mounjaro became India’s top-selling drug by value in October 2025, overtaking established blockbusters.
Here’s where it gets interesting.
Novo Nordisk’s key patents for semaglutide (used in Ozempic and Wegovy) in India are scheduled to expire in March 2026. This opens the door for generic manufacturers. Indian pharma giants like Sun Pharma, Dr. Reddy’s, and Lupin are already working on biosimilar versions that could bring costs down to ₹5,000-10,000 per month.At that price point, we’re talking about a potential market of 50-100 million Indians who could afford treatment, transforming GLP-1s from a luxury to a mainstream healthcare solution.
The ripple effects: Who wins and who loses
The arrival of effective weight-loss drugs is going to impact many more industries other than healthcare.
Pharma: The clear winners
Indian pharmaceutical companies are positioning aggressively:
- Sun Pharma has announced plans to launch biosimilar GLP-1s by 2026
- Dr. Reddy’s is investing in peptide manufacturing capacity specifically for obesity drugs
- Cipla and Lupin are exploring partnership models with global innovators
The market opportunity is enormous. If 10% of India’s obese population (10 million people) were on GLP-1 therapy at an average cost of ₹5,000/month, that’s a ₹6,000 crore annual market from generics alone. Premium branded versions could add another ₹10,000-15,000 crore.
QSRs and food delivery: The uncomfortable question
In the US, early data is already showing behavioral changes:
- Walmart and Target reported declining sales of snack foods in areas with high GLP-1 adoption
- PepsiCo and Nestlé have launched “GLP-1-friendly” product lines
- Restaurant traffic among GLP-1 users dropped 20-30% in some studies
Now consider India’s food landscape:
- QSR market size: ₹50,000+ crore and growing at 18-20% annually
- Food delivery GMV: ₹70,000+ crore (Zomato, Swiggy combined)
- Packaged snacks market: ₹35,000+ crore
If GLP-1 drugs achieve even 5% penetration among India’s urban population (roughly 5-6 million users), the impact on discretionary food spending could be material.
What is the impact?
- Store expansion becomes riskier if same-store sales growth slows
- Premium positioning matters more (GLP-1 users still eat out, but more selectively)
- Delivery-heavy models face margin pressure if order frequency drops
But this is not a real threat yet for us. India’s consumption story is far from over. But it does mean paying closer attention to:
- Unit economics rather than just store count growth
- Menu innovation toward healthier, protein-rich options
- International expansion into markets less affected by GLP-1 adoption
Fitness and wellness: Redefined, not dead
Contrary to the fear that GLP-1 drugs will kill gym memberships, early evidence suggests something more nuanced.
In markets with high GLP-1 usage, premium fitness chains are actually growing because people who lose significant weight often want to:
- Build muscle to improve body composition
- Maintain weight loss through sustainable habits
- Address loose skin and body image concerns
The shift is from weight loss as the primary goal to fitness as lifestyle maintenance.
Insurance and healthcare: A longer game
Here’s where things get really interesting for the long term.
If GLP-1 drugs reduce obesity at scale, we could see:
- Lower incidence of diabetes, heart disease, and joint problems
- Reduced healthcare costs over 10-15 year horizons
- Insurance premium adjustments as actuarial tables get rewritten
But there’s a catch: in the short to medium term, insurance companies will face pressure to cover GLP-1 drugs. In the US, this has already become a political flashpoint, with some insurers spending $1,000-2,000 per member per month on these medications.
In India, where private insurance penetration is still low (~35% of population) and out-of-pocket spending dominates, the question is who pays?
- Corporate health plans for high-value employees? Likely.
- Retail insurance as a standard benefit? Less likely in the near term.
- Government schemes like Ayushman Bharat? Not anytime soon.
For now, GLP-1s remain a self-pay luxury for India’s affluent, but that’s changing fast.
India vs. the world: How adoption will differ
India isn’t just a smaller version of the US market. Cultural, economic, and structural factors will shape adoption differently.
Price sensitivity dominates
In the US, many patients access GLP-1 drugs through insurance. In India, the majority of users are expected to pay out-of-pocket. That makes price the single biggest adoption driver.
At ₹30,000/month, you’re targeting India’s top 1-2% (HNI/UHNI segment).
At ₹5,000/month post-generics, you’re targeting the top 10-15% (affluent middle class).
At ₹2,000/month (if competition drives prices down further), you enter mass market territory.
Healthcare infrastructure
Unlike the US, where GLP-1 prescriptions often come from primary care physicians, India faces:
- Limited endocrinologist availability outside metros
- Telemedicine growth making prescriptions more accessible
- Pharmacy distribution challenges in tier 2/3 cities
This creates opportunities for digital health platforms that can provide remote consultations, prescription management, and doorstep delivery.
The uncomfortable truths we need to talk about
As someone who’s spent two decades in wealth management, I’ve learned that the most important conversations are often the uncomfortable ones.
This isn’t a magic bullet
GLP-1 drugs work, but they’re not without trade-offs:
- Gastrointestinal side effects: Nausea, vomiting, diarrhea affect users
- Muscle loss: Rapid weight loss can include lean muscle mass
- Rebound weight gain: Many patients regain weight after stopping treatment
- Long-term unknowns: We don’t have 20-year safety data yet
In India, where healthcare literacy varies widely, patient education and medical supervision will be critical. The risk of misuse especially among young people seeking cosmetic weight loss is real.
Economic inequality will widen
Here’s the uncomfortable reality: for the foreseeable future, GLP-1 drugs will be accessible primarily to India’s top 5-10% by income.
This creates a new dimension of inequality:
- Affluent Indians get access to effective obesity treatment
- Middle and lower-income Indians rely on diet, exercise, and limited healthcare access
- Health outcomes diverge further between economic classes
This isn’t unique to GLP-1s, it’s true of most medical innovations. But it’s worth acknowledging as we think about India’s health future.
In summary
The impact of GLP-1s is far more than we think it is. It involves –
- India’s pharma industry capturing a massive new market as patents expire
- Food and beverage companies adapting to changing consumer behavior
- Healthcare infrastructure evolving to support chronic medication management
- Wealth creators understanding how this trend can impact their portfolios
We’ve seen this pattern before. When statins democratised cholesterol management in the 1990s, they rewrote insurance actuarial tables, shifted pharma R&D priorities, and changed how people thought about preventive care. GLP-1s are following a similar trajectory, but at a scale and speed that’s unprecedented.
For wealth creators, the opportunity is in understanding that we’re at the beginning of a multi-decade shift in how India approaches health. The country that normalised processed foods and sedentary lifestyles in a single generation is now facing a reckoning and the solutions will come from a combination of medical innovation, infrastructure investment, and cultural change.
The companies that thrive won’t be those that ignore this trend or those that overreact to it. They’ll be the ones that adapt thoughtfully: pharma players who can scale manufacturing while maintaining quality, QSR chains that evolve their menus without losing their core appeal, insurance companies that find ways to balance coverage with sustainability, and digital health platforms that bridge the gap between innovation and accessibility.
In my experience, the greatest wealth creation happens at these inflection points, when a new technology or behaviour shift is still dismissed by the mainstream but the early signals are unmistakable. Is it time for us to sit up and pay attention to GLP-1s and their impact on India?