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Guide 2 of 9 · Stage: Understand

What do GLP-1 medicines do?

How semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) work in your body, what they can and can't do, and the risks.

GLP Guidebook teamUpdated 5 Oct 202613 min read42 sourcesWritten from published sources
The short answer

GLP-1 stands for glucagon-like peptide-1, a hormone your gut makes after you eat. GLP-1 medicines copy it. They help you feel full sooner, slow your stomach and help control blood sugar. Most weight loss comes from eating less. Common side effects are nausea and diarrhoea, and weight usually returns after stopping.

Key facts

What they are
Medicines that copy GLP-1, a gut hormone1
Main ones in India
  • Semaglutide: Ozempic, Wegovy, Rybelsus, and generics since March 20262,3
  • Tirzepatide: Mounjaro, Yurpeak4
Approved in India for
  • Type 2 diabetes: Ozempic, Rybelsus, Trulicity and others
  • Weight management: Wegovy
  • Both: Mounjaro and Yurpeak9,35,26,5,11,4
How weight loss happens
Mostly by eating less. They don't speed up the calories you burn at rest.6
Main risks
Nausea, diarrhoea and vomiting are common. Rare serious risks include pancreatitis and gallbladder problems. See the risks, in brief7
Prescription
Yes. A 1 Apr 2026 government statement says only endocrinologists, internal-medicine specialists or cardiologists can prescribe them.37,8 Committee minutes from CDSCO (India's national drug regulator) set a similar condition for some approvals, but we found no rule covering every brand.38,39
On this page
  1. What does GLP-1 mean?
  2. What do the medicines do in your body?
  3. Why do people lose weight on them?
  4. Do the results hold for Asian and Indian people?
  5. How is this different from metformin and other diabetes pills?
  6. Who these are for, and who they're not for
  7. Which GLP-1 medicines are sold in India?
  8. Is Ozempic the same as Wegovy?
  9. How long do they take to work, and how long do they last?
  10. Do they do anything besides weight and sugar?
  11. What these medicines do not do
  12. Are these medicines new?
  13. Questions people ask

What does GLP-1 mean?

GLP-1 is short for glucagon-like peptide-1. It's a hormone your gut releases after you eat, telling your body that food has arrived.

It's made mostly in the lower part of your small intestine and in your large intestine.1 It sends signals to your brain, stomach and pancreas (an organ behind your stomach that makes hormones).

Your body's own GLP-1 doesn't last long. An enzyme (a protein that breaks other things down) clears it in about 1 to 2 minutes.1 So its natural effect is small and short.

What do GLP-1 medicines do in your body?

A GLP-1 medicine is a lab-made version of GLP-1, changed so your body can't break it down quickly. Your own GLP-1 is gone in 1 to 2 minutes. Semaglutide, the GLP-1 medicine in Ozempic and Wegovy, keeps working for about a week.1,7

So the "food has arrived" message that your gut normally sends for a few minutes after a meal is sent all day, every day, and more strongly.

Your own GLP-1Made by your gut after you eatGone in 1 to 2 minutes
A GLP-1 medicineA weekly injection or a daily tabletKeeps sending the message all week

The message reaches four parts of your body

BrainYou feel less hungryThe part of your brain that controls appetite is told you've eaten, so you want less food and feel full sooner.Helps with weight
StomachYou stay full for longerYour stomach empties more slowly, so a meal stays with you longer before you feel hungry again.Helps with weight
PancreasSugar leaves your blood fasterYour pancreas (an organ behind your stomach) releases more insulin, the hormone that moves sugar out of your blood. It does this only when your sugar is high.Helps with blood sugar
LiverLess extra sugar is addedYour liver stores sugar and releases it when a hormone called glucagon tells it to. The medicine lowers glucagon when your sugar is high, so the liver adds less.Helps with blood sugar

Simplified. Based on a scientific review of GLP-1 and the US Wegovy label.1,7

In short: the brain and stomach effects are why people eat less and lose weight. The pancreas and liver effects are why these medicines lower blood sugar in type 2 diabetes.

Because the pancreas and liver effects only switch on when sugar is high, the medicine mostly leaves normal sugar levels alone. Sugar can still drop too low if it's taken with insulin or certain other diabetes pills.7

Why do people lose weight on them?

Mainly because they eat less. In a small study, semaglutide did not change the calories people burned at rest.6

That study gave 30 people semaglutide 1 mg or a dummy injection for 12 weeks each. On semaglutide, they ate 24% less across a full day of eat-as-much-as-you-like meals.6 They also reported less hunger and fewer food cravings.6

The two biggest weight trials are called STEP 1 (semaglutide, made by Novo Nordisk) and SURMOUNT-1 (tirzepatide, made by Eli Lilly). Each one worked the same way:

  • People were split at random into two groups. One group got the medicine. The other got a dummy injection with no medicine in it.
  • Both groups got the same diet and exercise advice, and nobody knew which injection they were on.
  • So the gap between the two groups is what the medicine itself added.12,13

Average weight lost. Kilograms are for someone who starts at 90 kg (198 lb).

STEP 1Semaglutide 2.4 mg, weekly

1,961 adults with obesity or overweight, without diabetes. 68 weeks.12

Semaglutide14.9%about 13 kg
Dummy injection2.4%about 2 kg
SURMOUNT-1Tirzepatide 15 mg, weekly

2,539 adults with obesity or overweight, without diabetes. 72 weeks.13

Tirzepatide20.9%about 19 kg
Dummy injection3.1%about 3 kg

Which works better? You can't tell by comparing the two cards above, because they were different trials with different people. One trial, SURMOUNT-5, tested the two medicines against each other in the same group of people. Each person took the highest dose they could manage.14 Tirzepatide also acts on a second gut hormone, called GIP (glucose-dependent insulinotropic polypeptide), which may help explain the difference.4

SURMOUNT-5Tirzepatide vs semaglutide, head to head

751 adults with obesity, without diabetes. 72 weeks.14

Tirzepatide20.2%about 18 kg
Semaglutide13.7%about 12 kg

People with type 2 diabetes usually lose less. STEP 2 ran the same test in people with diabetes: about 9 kg lost instead of 13 kg, on the same dose.12,15

STEP 2Semaglutide 2.4 mg, people with diabetes

1,210 adults with overweight or obesity and type 2 diabetes. 68 weeks.15

Semaglutide9.6%about 9 kg
Dummy injection3.4%about 3 kg

All of these are averages. Some people lose much more, and some lose very little.12

RisksThe risks, in brief
44%had nausea on Wegovy, vs 16% on a dummy injection7
24%vomited on Wegovy, vs 6% on a dummy injection7
  • Pancreatitis (a swollen, painful pancreas) has been seen. Severe stomach pain that may spread to the back is a warning sign.7
  • Gallbladder problems, such as gallstones, are more common.7
  • Dehydration from vomiting or diarrhoea can hurt the kidneys.7
  • Thyroid warning. Semaglutide caused thyroid tumours in rodents. The US label says people with a personal or family history of medullary thyroid cancer, or MEN 2 (a rare inherited condition that causes gland tumours), should not use it; tell your doctor if this applies.7
  • Not in pregnancy. Stop at least 2 months before trying for a baby.7
Full detail in Guide 5: Side effects and risks →
Weight usually comes back when you stop. In a STEP 1 follow-up, people had lost 17.3% on semaglutide. A year after stopping, they had regained about two-thirds of it, on average.16 More in Guide 9: Stopping

Not all the weight lost is fat. A scan study inside STEP 1 looked at 140 people. On semaglutide, fat fell by about 19% and lean mass by about 10%.17 In other words, people lost about a fifth of their fat and about a tenth of their lean mass. Lean mass means everything that isn't fat. It includes muscle, but also organs, bone and water.18 Guide 8 covers eating and exercise on these medicines.

Do the results hold for Asian and Indian people?

Trials in East Asian people show similar weight loss. None of these trials was in Indian people, and we found no large trial in Indians that measured heart attacks, strokes or deaths.

  • Japan and South Korea (401 people, STEP 6): 13.2% of body weight lost on semaglutide 2.4 mg over 68 weeks, vs 2.1% on a dummy injection.19
  • China (210 people, SURMOUNT-CN): 13.6% of body weight lost on tirzepatide 10 mg and 17.5% on 15 mg over 52 weeks, vs 2.3% on a dummy injection. The trial tested these two weekly doses.20
  • Japan (225 people analysed, SURMOUNT-J): people on tirzepatide lost about 16% (10 mg) and 21% (15 mg) more of their body weight than people on a dummy injection, over 72 weeks.21

None of these trials was in Indian people. South Asians tend to develop weight-related health problems at a lower BMI.22 Guide 1 explains India's lower BMI cut-offs.

How is this different from metformin and other diabetes pills?

GLP-1 medicines lower blood sugar and also reduce appetite. They can be taken on their own or alongside metformin.10

Metformin mainly stops your liver releasing too much sugar and helps your body use insulin better. It doesn't make your pancreas release more insulin.23

HbA1c is a blood test showing your average sugar over the past few months. In a 30-week trial of Ozempic on its own, HbA1c started around 8.1%. It fell by 1.4 to 1.6 points, vs 0.1 on a dummy injection.10 That means from about 8.1% to about 6.5–6.7%.

Watch for low blood sugar if you take other diabetes medicines. The risk goes up when GLP-1s are combined with insulin or sulfonylureas.7,10 Sulfonylureas include glimepiride and gliclazide, which can cause low sugar themselves.24,25 Doctors may lower the dose of these when starting a GLP-1.7

The type 2 diabetes path covers this in more detail: I have type 2 diabetes.

Who these are for, and who they're not for

In India they're approved for type 2 diabetes, and some brands for weight management. Whether they suit you is a decision for your doctor.

  • Type 2 diabetes: Ozempic, Rybelsus, Trulicity, Mounjaro, Yurpeak and others.9,35,26,11,4
  • Weight management: Wegovy (also sold as Poviztra), Mounjaro and Yurpeak.5,36,4
  • Teenagers: in May 2026, Wegovy was approved for ages 12 and up who weigh over 60 kg. It's used alongside diet and activity.27,5
  • Fatty liver with scarring (MASH): Wegovy was approved for adults with this in July 2026.5

A doctor may consider them if your BMI is over 27. Or over 25, with a related condition like high blood pressure or diabetes. This is the Endocrine Society of India's 2025 guidance.22 BMI is only one part of that decision.22 It's a point where a doctor may think about medicine. It is not the same as the BMI cut-offs that define obesity, which Guide 1 covers.

Not tested in type 1 diabetes. The US Wegovy label says its use in people with type 1 diabetes has not been studied.7 (A label is the official prescribing document for a medicine. We use the US one because we could not find the Indian one published online.)

Tirzepatide and birth-control pills. Tirzepatide (Mounjaro, Yurpeak) can make birth-control pills work less well. India's Endocrine Society says women on the pill should switch to a non-pill method, or add a barrier method such as condoms, when tirzepatide is started or the dose is raised.22 The US Mounjaro label says to do this for 4 weeks after starting and for 4 weeks after each dose increase.40

They're not for losing a few kilos before a wedding or event. They're long-term treatments, and weight tends to come back after stopping.16,28 If that's you, read I want to lose a few kilos.

Who shouldn't take them, and what to ask, is in Guide 4: Should I consider a GLP-1?

Which GLP-1 medicines are sold in India?

Every GLP-1 medicine has two kinds of name: the name of the medicine itself, and the brand names it's sold under. Knowing the difference stops a lot of confusion.

The medicineWhat actually works in your bodyThe same chemical, whoever makes it. Doctors and labels use this name.
e.g. Paracetamol
The brandThe name on the boxChosen by the company selling it. One medicine can have many brands.
e.g. Crocin, Dolo 650

GLP-1 medicines work the same way. Semaglutide is the medicine, and Ozempic, Wegovy and Rybelsus are three brands of it. Two brands of the same medicine can still differ in dose, in whether they're an injection or a tablet, and in what they're approved for.

A generic is a copy made by another company once the patent ends. Generic semaglutide went on sale in India on 21 March 2026.3

The four GLP-1 medicines sold in India, and their brands

MedicineSemaglutide →Weekly injection, or a daily tablet
  • OzempicNovo Nordisk · weekly injectionFor type 2 diabetes2,9
  • WegovyNovo Nordisk · weekly injectionFor weight management9,5
  • PoviztraNovo Nordisk's second brand, sold by Emcure36
  • RybelsusNovo Nordisk · daily tabletFor type 2 diabetes35
  • Generic brandsDr Reddy's, Zydus, Alkem, Sun Pharma, Glenmark and others, since March 20263
MedicineTirzepatide →Weekly injection
  • MounjaroEli Lilly · weekly injectionFor type 2 diabetes and weight11
  • YurpeakCipla · weekly injectionFor type 2 diabetes and weight4
MedicineDulaglutide →Weekly injection
  • TrulicityEli Lilly · weekly injectionFor type 2 diabetes26
MedicineLiraglutide →Daily injection
  • VictozaNovo Nordisk · daily injectionFor type 2 diabetes29
  • Generic versionsIncluding Glenmark, the first Indian-made version29

Names only, not a recommendation. Brands, doses, prices and recalls are in Guide 6.

India note. In July 2026, some batches of three generic semaglutide brands were recalled over an impurity. Dr Reddy's and Torrent said there was no risk to patients.30 Fake semaglutide pens have been found in several countries, so avoid sellers that skip the prescription.31,8 Prices vary a lot by brand and dose, and have fallen since generics arrived.32 Guide 6 covers recalls, fakes and cost

Is Ozempic the same as Wegovy?

Same medicine, different brand. Both are semaglutide, made by Novo Nordisk. They are approved for different uses and go up to different doses.

  • Ozempic is approved in India for type 2 diabetes. On the US label its highest dose is 2 mg a week.9,10
  • Wegovy is for weight management. Its usual full dose is 2.4 mg a week.7,5

In India, Ozempic is not approved for weight loss. Using it only for weight is "off-label", which means using a medicine for something it isn't approved for.9

Off-label isn't illegal. Doctors in India can prescribe a medicine off-label when they judge the benefit outweighs the risk. The rules on approved uses are aimed at the companies that make and market medicines, not at a doctor's prescription.41,42 You still need a prescription, and Wegovy is the semaglutide brand that is approved for weight.9

Mounjaro is a different medicine: tirzepatide, made by Eli Lilly.11

How long do they take to work, and how long do they last?

You start on a low dose and go up slowly, usually every 4 weeks. Weight loss builds over many months.7,12

In trials, stomach side effects happened mostly while the dose was still going up.13,14

Your doctor sets your dose. This is the US label schedule for Wegovy, shown so you know what to expect.7
  1. Weeks 1–40.25 mg once a week
  2. Weeks 5–80.5 mg
  3. Weeks 9–121 mg
  4. Weeks 13–161.7 mg
  5. Week 17 on2.4 mg, the usual full dose

The US label allows 1.7 mg as a long-term dose too.7 In STEP 1, average weight kept falling until about week 60, then levelled off.12

Why once a week, and how long it stays in your body

Your body clears semaglutide slowly. About half of each dose is gone after a week, so one injection a week keeps enough in your blood.1,7

The same slow clearing means the medicine doesn't leave your body the day you stop taking it. After your last dose, it takes about 5 weeks to leave your blood.10

This matters most if you're planning a pregnancy. The US label says to stop Wegovy at least 2 months before trying for a baby, to give it time to leave your body.7

Do they do anything besides weight and sugar?

In one large trial, semaglutide lowered the combined risk of heart attack, stroke and heart-related death. Most of that came from fewer heart attacks.

The SELECT trial followed 17,604 people for about 3 years.33 All were 45 or older, had overweight or obesity, and no diabetes. All already had heart or blood-vessel disease: a past heart attack, a past stroke, or narrowed leg arteries.7

6.5%had a heart attack, stroke or heart-related death on semaglutide33
8.0%did on a dummy injection

That's about 1 fewer event for every 67 people treated. Heart attacks fell from 3.8% to 2.8%. Strokes went from 2.0% to 1.8%, a difference too small to be sure of.7

This heart use is approved on the US Wegovy label.7 We could not confirm a matching approval in India. The result applies to people who already have heart or blood-vessel disease, not to everyone.

In India, Wegovy is also approved for fatty liver with scarring (MASH) in adults.5

What these medicines do not do

  • They're not a cure. On average, people regained two-thirds of the lost weight within a year of stopping.16
  • They don't burn fat. They work by cutting how much you eat, not by speeding up your body.6
  • They're not a short course. WHO treats obesity as a long-term condition needing lifelong care.28
  • They don't replace food changes. WHO and the labels pair them with healthy eating and activity.28,7

Are these medicines new?

No. The first GLP-1 medicine was approved in the US in 2005. What's new is how strong and long-lasting they've become.34

The first one, exenatide, came from a substance found in the saliva of a lizard, the Gila monster.1 Later versions were changed to last longer in the body. Half of each semaglutide dose is cleared in about a week.1,7

  1. 2005Exenatide (Byetta) approved in the US34
  2. Mar 2016Trulicity launches in India26
  3. Mar 2025Mounjaro launches in India11
  4. Jun 2025Wegovy launches in India5
  5. Dec 2025Ozempic and Yurpeak launch in India2,4
  6. Mar 2026Generic semaglutide launches in India3
  7. Jul 2026Some generic batches recalled; Wegovy approved for MASH30,5

Questions people ask

What is the full form of GLP-1?

Glucagon-like peptide-1. It's a hormone your gut makes after you eat.1

Is Ozempic for people without diabetes?

In India, Ozempic is approved for type 2 diabetes. Using it only for weight is off-label, which is not illegal when a doctor prescribes it.9,41,42 Wegovy is the same medicine, approved for weight management.5

Is a GLP-1 medicine the same as insulin?

No. Insulin lowers blood sugar directly. GLP-1 medicines help your body release its own insulin when sugar is high, and they also reduce appetite.1

Why is it an injection once a week?

Half of each semaglutide dose is cleared in about a week, which is why it's taken once a week.1,7 Your own GLP-1 lasts 1 to 2 minutes.1

Can food or supplements do the same thing?

Eating does release your own GLP-1, but your body clears it within minutes.1 The medicines are built to last about a week.7 Be wary of anything sold as a GLP-1 without a prescription.31

Do I need a prescription in India?

Yes. They aren't sold over the counter. A government statement of 1 April 2026 said only endocrinologists (hormone and diabetes specialists), internal-medicine specialists or cardiologists can prescribe them.37,8 Expert-committee minutes from CDSCO (India's national drug regulator) attach a similar condition to some approvals (endocrinologist or internal-medicine specialist), but we found no rule covering every brand.38,39 Guide 6 explains what that means for your family doctor.

Before you move on

  • GLP-1 medicines mostly work by making you eat less.
  • Ozempic and Wegovy are both semaglutide; Mounjaro is tirzepatide.
  • Stomach side effects are common, and there are rare serious risks.
  • They're long-term. Weight usually returns after stopping.
  • In India you need a prescription. A 2026 government statement says only certain specialists can prescribe them.
Side effects and risksShould I consider a GLP-1?I have type 2 diabetes
Was this guide easy to understand?

Sources

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  4. Cipla. Cipla launches Yurpeak (tirzepatide) for the treatment of obesity and type 2 diabetes. Press release, 10 December 2025. PDF
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Last checked 5 Oct 2026 · Next review due Jan 2027 · Report an error

How this guide was made. Written by the GLP Guidebook team from the sources above: published trials, drug labels and named news reports. Where we cite a label, it is the US label unless we say otherwise. It's general information, not medical advice. Talk to a qualified doctor before starting, stopping or changing any medicine. How we write