By Rishika Sadam

March 11 (Reuters) - India's drug regulator has warned

pharmaceutical companies against direct or indirect advertising

of weight-loss medicines, including obesity awareness campaigns

that could act as surrogate promotions, as global and domestic

drugmakers seek a share of the country's fast-growing obesity

drug market.

The Central Drugs Standard Control Organization, in an

advisory dated Tuesday, said any advertisement that exaggerates

therapeutic efficacy, guaranteeing weight-loss outcomes,

downplaying lifestyle changes or inducing demand for drug

therapy, could amount to misleading promotion, and merit

regulatory action.

The advisory reaffirmed India's existing drug rules that

prohibit advertising of prescription-only medicines to the

public.

Promotional activities, including what it described as

"so-called (obesity) awareness campaigns" that function as

surrogate advertisements for prescription drugs, could be

treated as misleading marketing practices, according to the

advisory, which was uploaded to the regulator's website on March

11 and reviewed by Reuters.

The move comes as global drugmakers Eli Lilly ( LLY ) and

Novo Nordisk, which launched their obesity drugs in

India last year, are scrambling to cement their lead in the

domestic market.

Both companies have increased outreach to doctors and run

aggressive campaigns highlighting obesity as a disease in public

spaces including airports, and on several digital platforms

including entertainment channels and social media as well as

through newspaper ads, according to doctors, analysts, medical

representatives, patients and distributors who previously spoke

to Reuters.

Lilly has also collaborated with Bollywood actors in a

social media campaign focused on obesity awareness.

The advisory said promotional activity under the pretext of

disease awareness, influencer engagement or corporate branding

that creates brand recall or visibility for a prescription

product would be treated as a violation.

India is projected to have the world's second-largest

overweight or obese population by 2050 in absolute terms,

according to global health estimates.

Domestic drugmakers are also preparing to launch cheaper

versions of Novo Nordisk's obesity drug once the patent on its

active ingredient, semaglutide, expires in India later in March.

"Obesity is a chronic metabolic condition requiring

comprehensive management, including lifestyle interventions,"

the advisory, signed by Drug Controller General Rajeev

Raghuvanshi, said.

Promotions of pharmaceutical therapy must not undermine

public health initiatives for preventive healthcare measures, it

said.