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Key Takeaways

On September 17, 2026, Sandalwood hosted the online session "Riding the Leap, Chasing the New Blue Ocean: 2026 China Weight-Loss E-commerce Market Insights." The session covered three themes: how GLP-1 weight-loss drugs are performing in e-commerce, consumer motivations and behavior along the treatment journey, and a live Q&A with an IQVIA industry expert on channel dynamics and future trends. Below are the highlights of the session.

01 Market performance: GLP-1 is the main growth engine of diabetes e-commerce

GLP-1 drugs hold 70% of the online diabetes market; JD Health and Alibaba Health dominate the channel

In the diabetes e-commerce market, JD Health holds a 58% share and Alibaba Health 33% — together the two platforms command the bulk of the market.

GLP-1 drugs are the main source of this growth: sales climbed from RMB 0.9 billion in 2025 to RMB 4.6 billion by July 2026 — a fourfold increase — lifting GLP-1 to 70% of the broader online diabetes category.

That trajectory is unusual in the out-of-hospital drug market.

New blockbuster drugs usually surge on long-backlogged clinical demand; GLP-1's growth path looks more like a consumer hit.

Understanding this market requires stepping outside the conventional pharma analytics framework.

Tirzepatide holds a 62% share; four leading products account for over 95% of the market

Tirzepatide (Mufengda) leads the weight-loss market with a 62% share — double its level a year ago.

Mazdutide (Xinermei) from Innovent ranks second, the fastest advance in the domestic camp.

Together with semaglutide (Nuoxinying) and enoglutide (Xianweiying) — all four explicitly approved in China for weight-loss indications — they hold more than 95% of the market.

For now, competition in GLP-1 weight loss is essentially a race among these four products.

02 Consumer insights: motivations, behavior paths, and experience pain points

Perceived efficacy and adherence rise over the treatment journey; the purchase experience remains the persistent weak spot

Comparing Q1 and Q2 2026 data, two findings stand out:

• Perceived efficacy and adherence climb with each stage of treatment; the purchase experience shows no improvement.
• Willingness to recommend posts the largest sequential increase of the three metrics.

P (perceived efficacy) and A (adherence) scores both rise as users move through treatment stages, but E (purchase experience) sits lowest at every stage with no sequential improvement — now the main constraint on retention.

Core word-of-mouth, though, has not slipped despite the weak purchase experience. Brands can focus on these high-propensity sharers and build referral programs to bring down acquisition costs.

Nearly 70% of users stay on the medication after side effects appear

Across 3,031 comments that explicitly mention side effects, three findings emerge:

• Gastrointestinal reactions are the most frequent side-effect type — 1,954 comments in total;
• Nearly 70% of users who notice side effects choose to stay on the drug; among gastrointestinal cases, 1,420 kept taking it;
• Injection-site reactions carry the highest discontinuation rate, mainly tied to needle fear, improper technique, or allergic response.

Efficacy drives product switching; trust drives channel switching

Switching behavior falls into two groups:

active switches — dose or regimen adjustments, moving to a competing product, or changing channel or store — and,

discontinuation — stopped, considering stopping, or pausing to observe.

Users who switch products cite insufficient efficacy above all (51%), so competition at the product level still hinges on real-world results.

Channel or store switching is driven mainly by authenticity trust, price, shipping and packaging, and customer service — a sign that trust in the drug itself and trust in the channel are two largely independent variables.

Five core user segments with clearly different goals and expectations

From 11,750 comments carrying clear user characteristics, the analysis identifies five core segments:

• Medical treatment (12.2%): glucose control or metabolic disease as the core goal, weight loss as an added benefit;
• Health management (3.9%): improving metabolism, easing physical burden, managing fatty liver or insulin resistance;
• Weight loss with unknown baseline weight (73.1%): the largest group — losing weight, controlling weight, or curbing appetite;
• Aesthetic body-shaping (6.0%): body shape, measurements, waistline, and how clothes fit;
• High-baseline weight loss (4.7%): starting weight, BMI, or weight-loss targets already at high levels.

Expectations and evaluation criteria differ sharply across the five segments — a single metric is not enough to judge how a product performs.

Spillover signals into adjacent categories

User comments also surface three spillover signals worth watching:

• Hair loss and muscle wasting: backed by clear physical evidence — already happening;
• Facial hollowing and skin sagging: mostly preventive concern, already swaying some users' decisions;
• Dropping clothing sizes and wardrobe replacement: a concrete consumption cue — apparel demand has already appeared.

03 Expert Q&A: selected highlights

On in-hospital channels, brand marketing, and future industry trends

In the live Q&A we were joined by Lucy, Director of Management Consulting and Consumer Health at IQVIA, for a discussion on in-hospital channels, brand marketing, and where the industry is heading. Selected highlights:

Q1: Do in-hospital data trends match the e-commerce market? How should the June–July growth inflection be read?

In-hospital and e-commerce are two largely separate ecosystems.

In-hospital and offline retail channels remain centered on diabetes; the weight-loss increment comes mainly from e-commerce. After last December's national reimbursement talks brought tirzepatide and peers under coverage, the in-hospital tone shifted to cost control, with sales value growing only single digits, while offline retail grew low double digits. The June–July turn was somewhat unexpected: offline retail fell sharply month on month in June and stayed low in July, and in-hospital volume and value both kept declining. Worth noting: GLP-1 was never a mainstream in-hospital category to begin with — its ecosystem differs greatly from e-commerce.

Q2: With limited resources, should brands prioritize new-customer acquisition or long-term adherence management?

Patient lifetime value deserves the greater weight.

Healthcare is an industry that rewards long-term value. Adherence management determines not only whether patients stay on therapy but also their propensity to recommend it to others. Brands should treat patients as users to be nurtured, using fine-grained segmentation to understand their life contexts and decision logic. Earning trust — not completing a one-off product use — is what wins patients.

Q3: Will multidisciplinary weight-management clinics and physical weight-loss centers replace the e-commerce model of traffic-driven drug sales?

Not a full replacement — but they point to where the future lies.

B2C channel growth will eventually plateau. Weight-management clinics, weight-loss centers, pharmacy health stations, and online-offline hybrids will be key directions for channel development. A business logic built purely on selling drugs cannot win the lasting trust of every patient.

Q4: What is the biggest uncertainty for this market over the next 6–12 months?

The uncertainty is about policy timing, not policy direction.

The main unknown is when policies land; the direction is already fairly clear: compliant growth will replace wild expansion, industry logic will shift from selling drugs to paying for outcomes, and AI agents will embed themselves further across the whole health-management journey.

Closing remarks

The weight-loss market is at a pivotal transition from wild expansion to regulated growth. The rapid roll-out of GLP-1 drugs is reshaping not just the diabetes and weight-loss treatment landscape, but also how consumers think about managing their health.

Truly valuable consumer insight goes beyond who is using these drugs and how well they work: it must explain why users start, where they hesitate, why they leave — and what new needs emerge along the way. That is what Sandalwood will keep tracking.

In a market this promising, pharma companies, platforms, and service providers alike need a deeper understanding of consumers, with more refined products and services. Riding the leap, chasing the new blue ocean — let's watch China's weight-loss market flourish together.

This article is compiled from Sandalwood's live session on September 17, 2026.