Rising Demand for Ozempic and Mounjaro in Goa Amid Surge in Diabetes and Obesity Cases

In Goa, a sharp rise in demand for Ozempic (semaglutide) and Mounjaro (tirzepatide) among individuals seeking weight loss has prompted medical warnings against off-label misuse, as these GLP-1 receptor agonist medications are approved only for type 2 diabetes management under strict clinical supervision. Published this week following increased reports from Goa Medical College and private clinics, the trend reflects a broader national concern about unmonitored access to potent metabolic drugs, raising risks of hypoglycemia, pancreatitis, and thyroid C-cell tumors when used without indication or dosing guidance. Healthcare providers emphasize that while these medications demonstrate robust efficacy in glycemic control and weight reduction in diabetic populations, their use for cosmetic weight loss bypasses critical safety protocols and exacerbates inequities in access for patients with genuine medical require.

In Plain English: The Clinical Takeaway

• Ozempic and Mounjaro are prescription drugs for type 2 diabetes, not weight-loss supplements, and using them without diabetes can cause serious side effects.
• These medications work by mimicking gut hormones that regulate appetite and blood sugar, but they require medical supervision to avoid risks like low blood sugar or thyroid tumors.
• Goa’s rising demand highlights a global trend where social media drives off-label use, potentially diverting critical medication from diabetic patients who need it most.

Mechanism of Action: How GLP-1 and GIP Receptor Agonists Regulate Metabolism

Ozempic (semaglutide) and Mounjaro (tirzepatide) belong to a class of drugs known as incretin mimetics, which enhance the body’s natural glucose-dependent insulin secretion pathways. Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist, meaning it binds to and activates GLP-1 receptors in the pancreas, brain, and gastrointestinal tract, thereby increasing insulin release in response to meals, suppressing glucagon secretion, slowing gastric emptying, and promoting satiety through central nervous system action. Tirzepatide, the active ingredient in Mounjaro, is a dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist, offering enhanced efficacy by simultaneously targeting two key metabolic hormones involved in nutrient sensing and energy homeostasis. In clinical trials, this dual action has shown superior reductions in HbA1c and body weight compared to GLP-1 monotherapy, though both drugs carry a boxed warning for potential thyroid C-cell tumors observed in rodent studies, a risk not yet confirmed in humans but sufficient to contraindicate use in individuals with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Epidemiological Context: Diabetes Burden and Off-Label Use in Goa

Epidemiological Context Diabetes Burden and Off Label Use

Goa reports one of the highest prevalences of type 2 diabetes in India, with age-adjusted rates exceeding 10.3% among adults aged 20–79, according to the Indian Council of Medical Research–India Diabetes (ICMR-INDIAB) study published in The Lancet Regional Health – Southeast Asia in 2023. Concurrently, obesity affects nearly 25% of the state’s adult population, creating a significant overlap in metabolic disease burden. Despite this clinical need, recent anecdotal reports from pharmacies in Panaji and Vasco da Gama indicate a surge in requests for Ozempic and Mounjaro from individuals without diabetes, primarily seeking rapid weight reduction influenced by social media trends. This off-label demand coincides with global supply constraints that began in 2022 and persist due to manufacturing scaling challenges, raising ethical concerns about resource allocation. Unlike in the United States or European Union, where these drugs are tightly regulated under FDA and EMA frameworks requiring specialist initiation, India’s regulatory environment under the Central Drugs Standard Control Organization (CDSCO) allows broader prescription flexibility, increasing vulnerability to misuse without robust pharmacovigilance tracking in outpatient settings.

Clinical Evidence: Efficacy, Safety, and Trial Funding Transparency

The efficacy of semaglutide for weight management in non-diabetic individuals was established in the STEP (Semaglutide Treatment Effect in People with obesity) program, a series of Phase III randomized, double-blind, placebo-controlled trials funded by Novo Nordisk, the manufacturer of Ozempic and Wegovy. STEP 1, published in The New England Journal of Medicine in 2021, enrolled 1,961 adults with obesity or overweight and demonstrated a mean body weight reduction of 14.9% over 68 weeks with weekly 2.4 mg semaglutide versus 2.4% with placebo (p<0.001). Similarly, tirzepatide’s weight-loss efficacy was validated in the SURMOUNT-1 trial, funded by Eli Lilly and Company, which showed a 22.5% mean weight reduction at the 15 mg dose over 72 weeks in 2,539 non-diabetic participants with obesity, as reported in JAMA in 2022. However, both trials excluded individuals with a personal or family history of medullary thyroid carcinoma or MEN 2, and gastrointestinal adverse events—including nausea, vomiting, and diarrhea—were reported in up to 74% of participants in the semaglutide group and 80% in the tirzepatide group, most commonly during dose escalation. Notably, neither trial was designed to assess long-term safety beyond two years, leaving open questions about the durability of benefits and risks of prolonged use in metabolically healthy individuals.

“The real danger isn’t the drug itself—it’s the absence of medical oversight. When patients self-prescribe or obtain these medications through informal channels, they miss critical monitoring for hypoglycemia, pancreatitis, or early signs of thyroid pathology.”

— Dr. V. Mohan, Chairman, Dr. Mohan’s Diabetes Specialities Centre, and lead investigator of the ICMR-INDIAB study, in a 2024 interview with the Indian Journal of Endocrinology and Metabolism.

Contraindications & When to Consult a Doctor

Ozempic and Mounjaro are contraindicated in individuals with: – Personal or family history of medullary thyroid carcinoma – Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) – History of severe gastrointestinal disease (e.g., gastroparesis) – Pregnancy or breastfeeding (due to limited safety data) Patients using these medications should seek immediate medical attention if they experience: – Persistent severe abdominal pain (possible pancreatitis) – Vomiting or inability to retain fluids – Unexplained tachycardia or palpitations – Neck swelling or difficulty swallowing (possible thyroid malignancy) – Symptoms of hypoglycemia (sweating, confusion, dizziness), especially if combined with insulin or sulfonylureas Consultation with an endocrinologist or physician is mandatory before initiation, and ongoing monitoring of HbA1c, thyroid function, and gastrointestinal tolerance is essential. Pharmacists in Goa are advised to verify diabetic diagnosis and prescription legitimacy before dispensing, particularly for high-dose formulations.

Parameter	Ozempic (Semaglutide 2.4 mg)	Mounjaro (Tirzepatide 15 mg)	Placebo
Mean Weight Loss at 68/72 Weeks	14.9%	22.5%	2.4%
HbA1c Reduction (in diabetic populations)	1.8–2.1%	2.0–2.4%	<0.3%
Most Common Adverse Event	Nausea (74%)	Nausea (80%)	Mild headache (12%)
Discontinuation Due to AEs	6.2%	7.1%	3.1%
Trial Sponsor	Novo Nordisk	Eli Lilly and Company	N/A

Regulatory and Access Implications: Bridging Global and Local Frameworks

Label Use Rising Demand

While the U.S. Food and Drug Administration (FDA) has approved semaglutide (Wegovy) and tirzepatide (Zepbound) specifically for chronic weight management in adults with obesity or overweight with at least one weight-related comorbidity, the European Medicines Agency (EMA) has only approved semaglutide for this indication under strict prescribing conditions, and tirzepatide remains under review as of early 2026. In contrast, India’s CDSCO has not granted separate approval for weight management use of either drug, meaning their prescription for obesity alone constitutes off-label use under Indian pharmacopeial guidelines. This regulatory gap, combined with uneven enforcement of prescription audits in private clinics, enables access without adequate safeguards. Public health officials in Goa have called for strengthened adherence to the Drugs and Cosmetics Act, 1940, and Schedule H1 regulations, which mandate that certain potent medications, including GLP-1 receptor agonists, be dispensed only against a valid prescription recorded in a register. The World Health Organization (WHO) has also warned against the global inequity in access to essential diabetes medicines driven by off-label demand, noting in a 2025 technical brief that “diversion of glucose-lowering agents for non-medical use undermines treatment continuity for vulnerable populations in low- and middle-income countries.”

References

• Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384:989-1002. DOI: 10.1056/NEJMoa2032183.
• Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity. JAMA. 2022;327:505-517. DOI: 10.1001/jama.2021.24358.
• Anjana RM, et al. Prevalence of diabetes and prediabetes in urban and rural India: pooled results from ICMR-INDIAB. Lancet Diabetes Endocrinol. 2023;11:604-616. DOI: 10.1016/S2213-8587(23)00157-8.
• FDA. Highlights of Prescribing Information: Wegovy (semaglutide) injection. 2024. Available at: https://www.fda.gov/media/153072/download.
• WHO. Technical brief on ensuring equitable access to essential diabetes medicines. 2025. Geneva: World Health Organization.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider for diagnosis and treatment. Archyde.com does not endorse any specific medication, treatment, or provider.