The Injection That Replaced Your Doctor With a Dose Chart

Semaglutide is arriving in clinics just as ultra-processed food has finished rewiring global diets. In The Snack Boom Is India’s Tobacco Moment, the column examined the money in manufacturing obesity. This piece looks at the money now being built around managing it.

In the span of one week, the semaglutide race in India reached several milestones. Sun Pharmaceutical Industries received Drug Controller General of India approval to launch the drug. An expert committee accepted Torrent Pharmaceuticals’ Phase 3 clinical trial report. MSN Laboratories and Natco Pharma received recommendations for manufacturing permission. The competitive intensity signals what pharmaceutical companies see coming.

Semaglutide is celebrated as a breakthrough in obesity medicine. A weekly injection that suppresses appetite, delivers visible weight loss, and improves metabolic markers. While it works for millions of patients, it is also the problem.

Semaglutide may turn out to be less a solution to obesity than a structural threat to obesity treatment itself. It may risk weakening medical discipline by replacing long-term behavioural work with a chemically managed shortcut.

Complexity Collapsed
Obesity medicine has evolved as one of the most multidisciplinary fields in healthcare over the years. It sits at the intersection of endocrinology, nutrition, psychology, exercise science and behavioural therapy. Treating obesity meant dealing with habits, environments, emotional triggers, food systems and long-term compliance. Semaglutide reduces all of that to a single molecule.

The first casualty is the multidisciplinary treatment model. Obesity care was built around teams of endocrinologists, dietitians, psychologists, exercise counsellors and behavioural therapists because obesity spans hormones, habits and environments. In the semaglutide era, the question increasingly becomes why retain a full cast when one drug appears to carry the show. For time-starved systems and cost-conscious insurers, the temptation is to sack the choir and keep only the soloist.

When a drug delivers reliable outcomes, clinical reasoning can shrink. There is less incentive to understand why people eat the way they do, to explore trauma, stress or loneliness as drivers of overeating, or to design long-term plans that can survive festivals, family pressure and relentless food advertising.

Why invest in school nutrition, urban design, physical activity or food guidelines when weight can apparently be chemically regulated. Semaglutide risks shifting healthcare from preventing obesity to managing it indefinitely. A preventable condition may become a managed dependency. Obesity gets reclassified from a public problem to a private prescription.

Patients post before-and-after photographs on social media. Weight falls and biomarkers improve, but the underlying disease structure remains largely untouched. Weight is often regained when the drug is stopped. Semaglutide treats the symptom metric, not the system that produced it.

Semaglutide also risks crowding out future obesity research. Behavioural interventions, nutritional science, urban-health studies and preventive models struggle to compete for funding and attention. When one molecule dominates clinical outcomes, capital allocation and media narratives, why back multi-year lifestyle trials. Obesity science narrows toward dose-response, while harder questions about food systems and behaviour remain under-explored.

Drug-based treatment offers predictable costs, scalable delivery and recurring revenue. Lifestyle interventions are slow, messy and difficult to monetise. Insurers prefer a clean monthly cost line. The business model of healthcare aligns neatly with semaglutide.

Treatment Abandoned
Semaglutide risks teaching a generation of clinicians that behaviour change is futile, prevention inefficient, and long-term lifestyle medicine may become obsolete. If every difficult obesity case can be addressed with a higher dose, the incentive to invest emotional and professional energy in counselling weakens. Obesity becomes something to manage, not something to understand.

The pattern is hard to miss. At one end, investors are pouring billions into ultra-processed food companies whose business model depends on engineering overconsumption. At the other, investors are lining up to fund molecules that promise to tame the consequences. One profit pool is built on making obesity. The other profit pool is built on maintaining it.

Between them sits the unglamorous work of prevention, behaviour, and environment that face the risk of being quietly pushed aside in obesity treatment.