Which GLP-1 is best for weight loss? What the trials show, and what India has

Each medicine below reduced weight more than a dummy treatment (placebo) did in its own trial^8,9,10,11.

Global trials, from each trial's PubMed abstract. The India column is as of 20 October 2026, from news reports and records of CDSCO, India's drug regulator. A trial result is not an Indian approval^4,8,9,10,11.

Each row is a separate trial with its own people. Only SURMOUNT-5 compared two medicines within one trial, so the gap between two other rows is not a direct comparison⁴.

In STEP 1, SURMOUNT-1, SURMOUNT-5 and ATTAIN-1, digestive side effects were the most common, and most were mild to moderate^4,8,9,11. OASIS 4 found them more often with oral semaglutide than with placebo¹⁰.

A government backgrounder from the Press Information Bureau (PIB) lists severe complications of GLP-1 medicines, including pancreatitis, kidney injury and bowel obstruction⁷. These signs need help without delay:

• A swollen throat or tongue, a raised itchy rash, or difficulty breathing. The UK's National Health Service (NHS) lists these as signs of a serious allergic reaction^19,20. Call 112, India's emergency number²¹.
• Severe stomach pain that does not go away and may reach the back, with or without vomiting. This may be a sign that the pancreas is inflamed²². The US Medication Guides of both medicines say to stop the medicine and call the doctor right away^23,24.
• A gut that seems blocked, or severe constipation. Get medical help straight away^7,24.

You can also report a suspected side effect to India's Pharmacovigilance Programme (PvPI) on 1800 180 3024, on working days^25,26. The other signs are on our page about GLP-1 side effects.

Eli Lilly, the maker of tirzepatide, funded SURMOUNT-5⁴. Every other trial in the first table was funded by its medicine's maker^8,9,10,11. SURMOUNT-5 was open-label, with no placebo group^4,5.

SURMOUNT-5 enrolled 751 adults with obesity who did not have type 2 diabetes, and each person took the highest dose they could tolerate⁴. Of them, 18 were recorded as Asian, a US race category²⁷. More people on tirzepatide than on semaglutide reached losses of at least 10, 15, 20 and 25 %⁴. Digestive side effects were the most common in both groups⁴.

Both medicines are sold in India, as Wegovy and Mounjaro among other brands^2,13. Our tirzepatide and semaglutide comparison sets the two side by side.

An average hides a wide spread. In STEP 1, the average loss on semaglutide 2.4 mg was 14.9 %, and 50.5 % of people lost 15 % or more, against 4.9 % on placebo⁸. In SURMOUNT-1, the average on tirzepatide 15 mg was 20.9 %, and 57 % lost 20 % or more, against 3 % on placebo⁹. On orforglipron 36 mg in ATTAIN-1, the average was 11.2 %, and 54.6 % lost 10 % or more, against 12.9 % on placebo¹¹. The table's averages are not a forecast for one person.

The full dose also takes months. Under the US label, the semaglutide dose for weight loss rises every 4 weeks from 0.25 mg and reaches 2.4 mg after 16 weeks²⁴. Under its US label, the tirzepatide dose rises in 2.5 mg steps, each after at least 4 weeks²³. In India, CDSCO records the approval of Wegovy as a prefilled pen in 0.25, 0.5, 1.0, 1.7 and 2.4 mg strengths¹. Ask your doctor how your dose will rise.

All five trials in the first table enrolled people without diabetes^5,8,9,10,11. In the US-label trials of both injections, people also received diet and activity advice^23,24.

Separate trials tested adults with type 2 diabetes^28,29. In STEP 2, the average loss on semaglutide 2.4 mg was 9.6 %, against 3.4 % on placebo²⁸. In SURMOUNT-2, it was 14.7 % on tirzepatide 15 mg, against 3.2 % on placebo²⁹. Digestive side effects were common in all of these trials, and most were mild to moderate^8,9,11,28,29.

Weight came back after treatment stopped, in trials of both medicines^30,31. A year after people stopped semaglutide 2.4 mg and the lifestyle programme, the STEP 1 extension found they had put back two-thirds of their earlier weight loss³⁰. In SURMOUNT-4, switching to placebo after 36 weeks on tirzepatide led to substantial weight regain³¹.

Semaglutide and tirzepatide injections are sold in India for weight management, each under more than one brand^1,2,3,12,14. According to PharmEasy, an Indian online pharmacy, both are Schedule H prescription medicines^32,33,34.

As of 20 October 2026, as reported in news, company releases, PharmEasy and CDSCO committee minutes^{2,13,15,18,35}.

The PIB backgrounder says GLP-1 drugs must be taken under medical supervision⁷. In April 2026, Haryana's drug regulator was reported to have seized more than 260 suspected counterfeit Mounjaro pens⁴². Get your medicine on a prescription, from a registered pharmacy^7,20.

For weight management in India, the GLP-1 forms on sale are injections: no Indian launch of the Wegovy pill or of orforglipron was found by 20 October 2026^15,18. The semaglutide tablets sold in India treat type 2 diabetes^16,40.

Under the US Wegovy label, the injection is taken on the same day each week, with or without food²⁴. The US Wegovy tablet is taken once a day on an empty stomach in the morning, with a little water²⁴. Orforglipron, approved in the US as Foundayo, is taken daily with or without food¹⁷.

ATTAIN-1 tested a trial form of orforglipron at 6, 12 and 36 mg^11,17. The US Foundayo label reports the same trial as 5.5, 9 and 17.2 mg of Foundayo, its highest dose, with −11.1 % at 17.2 mg¹⁷. In OASIS 4, digestive side effects affected 74.0 % of people on oral semaglutide 25 mg, against 42.2 % on placebo in that trial¹⁰.

A doctor matches the medicine to the person on points like these.

• The dose steps. In SURMOUNT-5, digestive side effects came mostly during the dose increases⁴.
• Thyroid history. The US labels bar both medicines for people with a personal or family history of medullary thyroid cancer, or with MEN 2 (multiple endocrine neoplasia type 2)^23,24. This cancer starts in the C cells of the thyroid⁴³. Both medicines caused thyroid C-cell tumours in rodents, and whether they do so in people is not known^23,24. Mention any such history, yours or your family's, to your doctor.
• Pregnancy and the pill. The US labels say to stop semaglutide for weight loss in pregnancy, and to stop tirzepatide once a pregnancy is recognised^23,24. Under its US label, tirzepatide may make the contraceptive pill less effective²³. Tell your doctor if you take the pill, plan a pregnancy or become pregnant.
• BMI. Mounjaro was reported to have been launched in India for adults with a BMI of 30 or more, or 27 or more with a weight-related condition³. In June 2026, CDSCO's expert committee kept the BMI cut-offs in tirzepatide's Indian indication, because obesity and overweight are defined differently for US and Asian populations⁴⁴. Our page on who should not take these medicines lists the other limits.
• Generics. Generic semaglutide brands have been sold in India since March 2026, some for type 2 diabetes only, while no generic tirzepatide exists there, as reported^35,36,38. A dated brand list, with price ranges is on a separate page.

Talk to a Zelta specialist about which of these points apply to you, and bring your health history and the list of medicines you take.

Which GLP-1 works fastest? The results in the table do not answer that. Each trial reports its main result at the end, after 64 to 72 weeks^4,8,10.

What happens in the first 2 months? The first 2 months fall inside the low-dose steps. Under the US label, semaglutide is taken at 0.25 mg in weeks 1 to 4 and at 0.5 mg in weeks 5 to 8²⁴. Under its US label, tirzepatide starts at 2.5 mg a week for 4 weeks²³. No doctor can promise you a result.

Which is better for weight loss, Wegovy or Ozempic? Of the two, Wegovy is the one approved in India for weight management, and both contain semaglutide^1,34. Ozempic is sold here in 0.25, 0.5 and 1 mg strengths, and PharmEasy says it is approved in India only for type 2 diabetes^34,45.

What is the strongest weight-loss pill without a prescription? No GLP-1 medicine qualifies: according to PharmEasy, semaglutide brands and Mounjaro are Schedule H prescription medicines in India^33,34. In India, a tablet listed as "Glp 1mg" contains glimepiride, a diabetes medicine that can cause low blood sugar, and not a GLP-1 medicine, according to PharmEasy^46,47. Low blood sugar can cause sweating and shaking¹⁹. With diabetes, the NHS says to treat it quickly, for example with a small glass of fruit juice⁴⁸. Then tell your doctor. If someone who took it may have very low blood sugar and is not responding normally, call 112^21,47,48. Give an unconscious person nothing to eat or drink⁴⁸. Read what GLP-1 supplements and patches contain.

Is tirzepatide a GLP-1? In part, yes. Tirzepatide acts on the GLP-1 receptor and on a second hormone receptor, GIP²³. Semaglutide acts on the receptor for GLP-1, a gut hormone that helps regulate appetite²⁴.

Is liraglutide still used? Liraglutide is still sold in India, for uses the report does not give; it held about 2 % of GLP-1 sales in the year to April 2026⁴⁹. In the SCALE trial, people without diabetes took liraglutide 3.0 mg daily for 56 weeks⁵⁰. Of them, 63.2 % lost at least 5 % of their weight, against 27.1 % on placebo⁵⁰. Its most frequent side effects were mild or moderate nausea and diarrhoea⁵⁰.