Injectable Semaglutide (Wegovy) in India: Promise, Pitfalls and the Way Forward

The approval and launch of subcutaneous semaglutide (Wegovy) in India on 24 June 2025 represents a landmark event in the management of obesity and type 2 diabetes mellitus. Semaglutide, a long-acting glucagon-like peptide-1 receptor agonist, has demonstrated unprecedented efficacy in weight reduction, glycaemic control and cardiovascular protection in global clinical trials. For India, where metabolic disorders are rising sharply, Wegovy provides a new therapeutic opportunity. Its once-weekly subcutaneous regimen promises improved adherence and convenience. However, high pricing (₹17,000–26,000/month) threatens equitable access, and side effects such as gastrointestinal intolerance and gallbladder disease raise concerns. Furthermore, the scarcity of real-world South Asian data, the risk of off-label cosmetic misuse, and dependence on pharmacological solutions without lifestyle integration demand caution. This review, reflecting the perspective of an Indian researcher, combines international evidence with domestic challenges to provide a comprehensive assessment. We argue that semaglutide’s success in India will depend on affordability through generic entry, rational prescribing, robust pharmacovigilance and integration into preventive care frameworks. A balanced, evidence-driven and India-centric approach is essential to ensure that this breakthrough reaches beyond privileged groups and contributes meaningfully to reducing India’s obesity and diabetes burden.