Mounjaro Steps Into India: Could It Transform Obesity Treatment?

Dr Sunil Kumar Kota MD (Med), DrNB (Endocrinology)

According to the National Family Health Survey-5 (2022), 23% of Indian women and 22.1% of men are overweight based on BMI, with abdominal obesity affecting up to 40% women and 12 % men. This silent epidemic significantly raises the risk of diabetes, hypertension, cardiovascular disease, obstructive sleep apnea, and joint issues. Until recently, treatment options in India were largely limited to lifestyle interventions and older medications like Orlistat, which generally delivered modest results.

Mounjaro (Tirzepatide), known to aid in weight loss of up to 22% (a figure comparable to results from bariatric surgery) has finally made its debut in India this

March, as an once a week subcutaneous injection. Touted as one of the most talked about drugs since the COVID-19 vaccine, Mounjaro has captured global attention. Initially it was approved by the U.S. FDA in May 2022 for type 2 diabetes and in November 2023 for chronic weight management. The current launch in India is backed by about 1 and half year of international experience of its usage.

The delayed Indian launch is attributed to the soaring global demand, prompting manufacturersto focus on more established markets first. Another crucial factor was to make it more affordable and accessible for Indians.

More Potent Than Ozempic and Wegovy

Tirzepatide has dual-action mechanism- it targets both GLP-1 and GIP receptors. This gives it an edge over other globally approved weight-loss medications like liraglutide (marketed as Saxenda) and semaglutide (marketed as Ozempic and Wegovy), which act solely on the GLP-1 receptor. Tirzepatide promotes weight loss by supressing appetite and promoting satiety by means of its effect on hypothalamus in brain; slowing the emptying of food from stomach thereby increasing the sense of fullness; improving insulin action and metabolism by reduction of fat storage, stimulation of fat breakdown and by reducing cravings for high calorie and high fat foods.

Older weight-loss medications usually result in just a 5–8% reduction in weight, while injectable semaglutide (Wegovy) performs better with an average weight loss of
around 15%. Tirzepatide can lead to weight loss of up to 22%, approaching the 25–
30% typically achieved through bariatric surgery.

Many individuals struggle to lose weight despite genuinely committing to diet and exercise. Introduction of Tirzepatide and the upcoming availability of injectable semaglutide (Wegovy)—has the potential to redefine obesity treatment across the country by offering a much-needed alternative

More Than Just a Trend—It’s a Medical Breakthrough That Deserves Serious Attention

These next-generation treatments do more than aid weight loss- manage diabetes (1.5-2.4 % HbA1C reduction over 40-52 weeks of treatment as per SURPASS Trials), with potential heart and liver health protection. In the United States, it is marketed in pen form, whereas in India, it is sold in Vial form making 80% cheaper in
India than in the U.S.
 

The SURMOUNT clinical trials demonstrated: after 72 weeks, participants lost an average of 15% of their body weight on the 5 mg dose, 19.5% on the 10 mg dose, and 20.9% on the 15 mg dose. By comparison, the people in the placebo group, lost just 3.1%. The SURMOUNT- OSA Clinical trial has demonstrated benefits in treating Obstructive sleep Apnea (a condition associated with night time snoring, excessive day time sleepiness and lethargy), making it the only drug approved for treatment of
Sleep Apnea by USFDA in December 2024.

Managing Side Effects and Safety Concerns with Tirzepatide

Gastrointestinal side effects are relatively common. Nausea, constipation and diarrhea were noticed in 31%, 17% and 23% participants of the clinical trials,
respectively. Most symptoms are mild and tend to resolve over time, between 4–7% of patients discontinue the medication due to intolerance. To reduce these effects, the treatments is typically begun followed by gradual upscale- allowing the body time to adjust and minimizing digestive discomfort.

Tirzepatide is contraindicated in patients with medullary thyroid cancer and pancreatitis. Rapid weight loss can also increase the likelihood of gallbladder complications, such as gallstones or cholecystitis—reported in about 0.6% of trial participants.

A 2024 study showed that participants who discontinued the drug regained about 14% of the weight they had lost within a year. Contrarily, those who stayed on the medication lost and additional an additional 5.5% weight over the same period. This raises an important, yet unresolved question: how long should patients remain on
the medication?

So far, current data supports the use of newer anti-obesity medications like Tirzepatide as an effective supplement when diet and exercise alone are not enough, with the benefits far outweighing the risks. However, as with any new therapy, ongoing research and careful monitoring are key to ensuring safety while maximizing benefit.

 

(DISCLAIMER: This is an opinion piece. The views expressed are the author’s own and have nothing to do with OTV’s charter or views. OTV does not assume any responsibility or liability for the same.)