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Reading path5 guides, in order

I'm thinking about a GLP-1 for my weight. Where do I start?

A reading path for anyone weighing up Wegovy, Mounjaro or a generic semaglutide, in the order that makes the decision easier.

GLP Guidebook teamUpdated 5 Oct 20264 min read13 sourcesWritten from published sources
The short answer

Start with your health, not the medicine. Indian doctors use lower BMI and waist cut-offs to judge risk. Medicines are one option, alongside food, activity and sometimes surgery. GLP-1s are usually long-term, need a specialist's prescription, and have side effects. These five guides walk you through the decision in order.

Read this page first. It covers what the Indian cut-offs mean for you, how to make the decision and what to expect if you start. At the end, five guides take you further, in order.
On this page
  1. Indian cut-offs
  2. The decision, step by step
  3. What to expect
  4. The risks, in brief
  5. What to read next
  6. Sources

What do the Indian cut-offs mean for me?

They measure health risk. They don't decide whether you should take a medicine.

BMI (body mass index) compares your weight with your height. Waist size shows how much fat sits around your belly.

Asian Indians tend to carry more body fat at the same weight. So Indian experts set lower cut-offs than the global ones.1

MeasureIndian cut-off
BMI 23 to 24.9Overweight1
BMI 25 or moreObesity1
WaistAbove 90 cm (35.4 in) in men, 80 cm (31.5 in) in women1

These are the cut-offs from India's 2009 consensus.1 A newer 2025 proposal from the India Obesity Commission (Misra and colleagues) counts a BMI above 23 as obesity, sorted into Stage 1 or Stage 2.10 Guide 1 explains both.

Medicines come in at a higher line. India's 2025 obesity guideline, from the Endocrine Society of India (ESI), says a doctor may consider them from a BMI above 27.2 Or above 25, if you also have a weight-related condition such as high blood pressure, diabetes or sleep apnoea.2

A number is not a prescription. Being over a cut-off means a specialist may consider a medicine. It doesn't mean you qualify. It's a starting point for a conversation with a doctor.

How should I make the decision?

One step at a time, in this order. Each step has a guide.

1Check your numbers and health (Guide 1)
2Compare all your options (Guide 3)
3Ask if a GLP-1 fits you, and when not (Guide 4)
4Weigh the side effects (Guide 5)
5See a specialist; learn the medicines and costs (Guide 6)
6Choosing a clinic or programme? Check it first (Guide 7)
7Review how it's going at 3 and 6 months

Medicines don't replace food and activity changes. The WHO says GLP-1 treatment should come with support for healthy eating and physical activity.4

Step 5 means a specialist. A government statement of 1 April 2026 said only endocrinologists (hormone and diabetes specialists), internal-medicine specialists and cardiologists (heart specialists) can prescribe GLP-1 medicines.11,3 Minutes of expert committees at CDSCO, India's central drug regulator, attach a similar condition to some approvals (endocrinologist or internal-medicine specialist), but we found no rule covering every brand.12,13

The review step matters too. India's ESI guideline suggests a 3-month trial period to check whether a medicine works and suits you.2 In the UK, NICE (the body that advises England's health service)5 says to consider stopping semaglutide if you've lost less than 5% of your body weight after 6 months.5

What should I expect if I do start?

Expect three things:

  • weight loss that is real, but varies a lot from person to person
  • stomach side effects for many people, especially early on
  • a long-term commitment, because the weight tends to return after stopping

The main semaglutide weight trial, STEP 1, shows what to expect. People were put into two groups at random. One group got the medicine and the other a dummy injection with no medicine in it. Both groups got the same diet and activity advice. So the gap between the two groups is what the medicine added.6

Average share of body weight lost, and what that means for someone who starts at 90 kg (198 lb):

STEP 1Semaglutide 2.4 mg (Wegovy), weekly

1,961 adults with obesity or overweight and no diabetes, 68 weeks.6

Semaglutide14.9%about 13 kg
Dummy injection2.4%about 2 kg

So about 12.5% of body weight, or 11 kg for a 90 kg person, came from the medicine itself.

These are averages, and people varied a lot. On semaglutide, about 86 in 100 lost at least 5% of their body weight, against about 32 in 100 on the dummy injection, and about 1 in 3 lost 20% or more. Put the other way, about 1 in 7 on semaglutide lost less than 5%.6

Most of the weight usually comes back after stopping. A year after stopping, people followed up from STEP 1 had regained about two-thirds of what they lost.7 So plan as if you'll stay on it, and budget for that. Guide 9 covers stopping.

Just a few kilos?It's for a family memberBMI calculator

What to read next, in order

These five guides go deeper. Each one ends with a link to the next, so you can read them one after another.

  1. 1Do I have obesity? What Indian BMI and waist numbers meanGuide 1 of 9UnderstandCheck where you stand with Indian BMI and waist numbers, and what they say about your health.
  2. 2Your options, and where medicines fitGuide 3 of 9DecideSee lifestyle support, other medicines, GLP-1s and surgery side by side before you pick one.
  3. 3Should I consider a GLP-1? And when not toGuide 4 of 9DecideWho doctors may consider for a GLP-1, and the times it isn't a good idea.
  4. 4Side effects and risksGuide 5 of 9DecideWhat the first weeks feel like, and the rarer risks to know before you start.
  5. 5Seeing a doctor, and the medicines in IndiaGuide 6 of 9Do it safelyWho may prescribe in India, the brands and generics, fakes, and the all-in cost.
  6. 6Choosing a doctor, clinic or programmeGuide 7 of 9Do it safelyIf you are looking at an app, clinic or programme: what they offer, how they charge and what to check.
Was this page easy to understand?

Sources

  1. Misra A et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians. Journal of the Association of Physicians of India, 2009;57:163–170. PMID 19582986. PubMed
  2. Madhu SV, Kapoor N, Das S et al. ESI clinical practice guidelines for the evaluation and management of obesity in India: an update (2025). Indian Journal of Endocrinology and Metabolism, 2025;29(4):355–365. Recommendations B.1 and D.3. DOI
  3. Outlook India. Inspections, surveillance to continue against unauthorised sale, promotion of GLP-1 weight-loss drugs: Govt. 1 April 2026. Link
  4. World Health Organization. WHO issues global guideline on the use of GLP-1 medicines in treating obesity. 1 December 2025. Link
  5. NICE (UK). Semaglutide for managing overweight and obesity. Technology appraisal TA875, recommendation 1.2. Declared interests: some invited clinical experts declare fees or grants from Novo Nordisk and Eli Lilly (NICE's own register of interests for this appraisal). Link
  6. Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). NEJM, 2021;384:989–1002. 1,961 adults without diabetes, 68 weeks. DOI
  7. Wilding JPH et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes, Obesity and Metabolism, 2022;24(8):1553–1564. 327 people followed for a year after stopping. DOI
  8. Novo Nordisk. Wegovy (semaglutide) US prescribing information, revised June 2026. Sections 1, 2.2, 5.2, 5.3, 5.5, 8.3, 17. (US label.) PDF
  9. Novo Nordisk. Ozempic (semaglutide) injection, US prescribing information and Medication Guide, revised May 2026. Sections 4, 5.3, 5.5, 5.6, 7.2, 8.5. (US label; India's CDSCO label is not published online.) PDF
  10. Misra A, Vikram NK, Ghosh A et al.; India Obesity Commission. Revised definition of obesity in Asian Indians living in India. Diabetes & Metabolic Syndrome, 2025;19:102989. Declared interests: the lead author declares grants, lecture fees and travel from Novo Nordisk and Eli Lilly, and from Indian makers including USV, Lupin, Cipla and Glenmark; a second author declares grants and lecture fees from Cipla, USV and Lupin (paper's own declaration). DOI
  11. Press Information Bureau (PIB Research). GLP-1 Drugs: Use, Risks, and Regulation ("In India, GLP-1 drugs can only be prescribed by endocrinologists, internal medicine specialists, and cardiologists"). 1 April 2026. PDF
  12. CDSCO. Subject Expert Committee (Endocrinology & Metabolism), recommendations of 20–21 April 2023, tirzepatide ("The drug should be sold by retail under prescription of Endocrinologist or internal medicine specialists only"). PDF · Archived copy
  13. CDSCO. Subject Expert Committee (Endocrinology & Metabolism), recommendations of 13–14 February 2024, semaglutide (approved warning: "To be sold by retail on the prescription of an Endocrinologist, and Internal medicine"). PDF · Archived copy

Last checked 5 Oct 2026 · Next review due Jan 2027

How this page was made. Written by the GLP Guidebook team from the sources above: drug labels, published trials, Indian and international guidelines, and named news reports. It's general information, not medical advice. Talk to a qualified doctor before starting, stopping or changing any medicine. How we write