-Essay-
HAMBURG — Humanity doesn’t often get a chance to conquer its most primal forces. We’ve learned to harness fire, water, steam and nuclear energy. We’ve even taken the reins on our instincts, planning reproduction, medicating our minds and now, it seems, controlling hunger itself.
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Enter Ozempic. Since 2017, this drug has represented a seismic shift in treating obesity. Developed by the Danish pharmaceutical giant Novo Nordisk to manage type 2 diabetes, its active ingredient, Semaglutide, had an unexpected bonus: Users reported feeling significantly less hungry, losing weight quickly, and even shedding cravings for cigarettes and alcohol.
An injection to banish our inner demons: It’s modern sorcery. Now, competitors like American pharmaceutical company Eli Lilly are jumping into the pharmacological fray, bringing new drugs to the table. But Ozempic, the first of its kind, has become synonymous with this breakthrough.
Drug of the hour
A medicine always has an active ingredient name and a trade name. Semaglutide is the name of the active ingredient contained in the preparations with the trade names Ozempic and Wegovy, both made by Novo Nordisk). Tirzepatide is the name of the active ingredient of Eli Lilly’s Mounjaro.
These discoveries, like any new tool in our hands, threaten to deepen social divisions and rifts: Obesity is one of the biggest global health problems. But how do we deal with this finding while, at the same time, the stigmatization of overweight people is one of the biggest social problems of our time? How do we solve one without exacerbating the other?
By 2025, the World Health Organization (WHO) projects that 3 billion people will meet the criteria for being overweight, defined by a body mass index (BMI) over 25. Among them, 1.2 billion will be classified as obese, with a BMI over 30. The annual costs associated with obesity — including healthcare, early deaths, and lost productivity — are already staggering. They account for 2.5% of global economic output, roughly the same as the financial toll of the COVID-19 pandemic, but occurring year after year.
Feeling full is bad for business
The food industry bears much of the responsibility for the global obesity epidemic. Its ultra-processed products, packed with fats, sugars and salts, are engineered to bypass our natural satiety signals. They exploit our biology, fooling our bodies into consuming more calories than we need. Feeling full after all, is bad for business, so the industry has perfected the art of switching off those signals.
WHO Secretary General Tedros Ghebreyesus is calling on the food industry to finally take responsibility for the health effects of its products. The world’s largest food company, Nestlé, had to state that less than half of its food can be classified as healthy according to the international Health Star Rating System.
Some corporations make billions by fattening us up; others rake in profits by slimming us down.
We are fattened using the same method as cattle, bestselling author Johann Hari notes in his recently published book Magic Pill, in which he also writes very personally about his experiences with the weight loss injection. A combination of sugar and fat similar to the drinks and food we consume daily only occurs in one food found in nature: breast milk, writes Hari quoting Cambridge neuroendocrinologist Giles Yeo. We slurp the shakes and soft drinks like babies drink from the breast, Yeo explains.
From a broader perspective, this feels like a harbinger of our self-destruction. The planet is heating up, species are vanishing and natural habitats are being obliterated — all because of humanity’s insatiable appetite for consuming, traveling and, of course, eating.
In this context, Ozempic appears as the capitalist system in its purest form. Some corporations make billions by fattening us up; others rake in profits by slimming us down.
If heroin was legal
This cycle is reminiscent of economist Joseph Schumpeter’s satirical suggestion in 1942 that the government could bury boxes of money and pay people to dig them up as a way to reduce unemployment. Fattening people up only to inject them back into slimness is similarly absurd, a pointless cycle that adds no real value to humanity. We could have just produced healthier food in the first place.
But that’s not true at all. We couldn’t have produced healthier food, no way. That doesn’t fit with the logic of capitalism. It exploits not only nature, but also our desires. If one company doesn’t do it, it disappears from the market and another takes over. If heroin were legal, there would be heroin companies worth billions listed on the stock exchange.
From a critical point of view of capitalism, all of this is extremely consistent. Some 150 years ago, Karl Marx wrote about how the bourgeoisie raced across the globe to open up ever larger sales markets. Marx called this process primitive accumulation.
It was about opening up new territory for capitalist expansion: Farmers were driven out, communal land was privatized, there was plundering through colonialism, there were dispossessed or enslaved people who were forced to give up their labor in order to produce surplus value for the capitalists.
It’s about us
Today, large parts of the earth have long been developed, everything that can be profitable has its price tag, all that is not can be destroyed, converted or used as a waste dump: see deforestation of the rainforests, overfishing of the oceans, an atmosphere used as a CO₂ garbage dump. That is why other things have to be valued today, above all: us.
Our social relationships and desires have long since been monetized. We call it social media. Now, the biochemical mechanisms behind our hunger are being commodified, too. Soon enough, even aging itself will likely be delayed and turned into a product for sale.
On a social, global and planetary level, Ozempic is therefore a horseman of the apocalypse. Problems are exploited for profit reasons and, if necessary, made worse — and by no means solved: Novo Nordisk is not a charity company, it charges huge sums for Ozempic and Wegovy, especially in the United States, simply because it can.
The wealthy and super-rich inject themselves with Ozempic, Wegovy and Mounjaro to look great on Instagram.
Bernie Sanders, chairman of the U.S. Senate Health Committee, wrote an angry letter to Novo Nordisk CEO Lars Fruergaard Jørgensen, saying “as important as these drugs are, they will be of no use to the millions of patients who cannot afford them.”
It all boils down to a society in which overweight people are not only often excluded and humiliated and, therefore, have worse job and career prospects. They also cannot afford the new, effective means of combating obesity: ,000 for a month’s supply in the U.S., €300 in Germany. In the meantime, the wealthy and super-rich inject themselves with Ozempic, Wegovy and Mounjaro to look great on Instagram.
But there is also the second level, the individual level. If you ignore all the medical pitfalls of Ozempic — side effects and unknown long-term consequences of use — then it is not really a matter of concern to anyone whether Marx would see the weight loss injection as a capitalist exploitation of our feeling of satiety.
It rewires the brain
Marx would probably have injected Ozempic himself if he had needed it: His liver, eyes, back rheumatism, he was plagued by many other contemporary ailments. “The hemorrhoids have affected me more than the French Revolution,” Marx wrote to Friedrich Engels in 1852. Whenever Marx had the money he would swallow all kinds of remedies — he “medicated the liver,” he wrote, for example, in 1852.
It’s a complex situation: While Ozempic perpetuates the damage caused by the food industry, it also mitigates it. Excess weight is linked to cardiovascular disease, diabetes and cancer. But high-calorie diets also rewire the brain, locking people into cycles of overconsumption. Ozempic offers a way to escape this trap, but it doesn’t address the root causes.
Insight that Ozempic could help to spread but probably won’t: “We could recognize metabolism and appetite as biological facts rather than moral decisions,” writes The New Yorker magazine. But instead, the drug seems to have led to a new fixation on being thin. It is difficult to say whether this is also happening here in Germany; Ozempic and the other weight loss injections are only just beginning to become well known here.
Capitalism not only produces the products, but also the people who demand them.
But the pressure to achieve physical perfection is also present in our society. And in such a social environment, Ozempic can be like a weapon in the wrong hands, only fueling our excessive self-optimization. We treat ourselves like a brand, right down to the very last profile picture. Our social market value is constantly on display — an automatism that is hardly questioned anymore. The result is a conformist ideal of beauty, now achievable by injection or, even easier, by pill. The active ingredients are likely to come onto the market in this form soon.
The whole development, let’s call it mass individualism, springs from the same spirit as industrial food and Ozempic: Capitalism not only produces the products, but also the people who demand them, which in turn leads to the products. An eternal feedback loop. So what can we do about it? Let’s go through the options.
Communal beet soup
The first is a little boring. You can use laws to force food companies to offer healthier products. Not necessarily in the sense that the European Commission interferes in the recipes, but you can ban advertising for unhealthy foods, require much better labeling, tax sugar or certain fats. Such points can also be found in an action plan that the WHO has developed for 2023. But overall, society as a whole needs to change something, states the report.
The second option is to return to our roots: healthy root vegetables, consumed in a pre-industrial setting. We all cook beet soup together in village communities, metaphorically speaking.
Both of these would need to be market-based approaches: Either the rules of the market change, or the customers change, or both. The customer thing won’t work because eating pre-made industrial food may look like an individual decision at the supermarket checkout, but the majority of frozen ready meals sold are due to a lack of time. If you have three jobs because rents have doubled, you can’t cook every day. For many people, fast food is a necessary means of getting something into their stomachs in hectic, real-world capitalism.
A revolution. Why not?
And even these new rules for corporations would only help in a world where there is actually a functioning market. The principle that Schumpeter called “the creative destruction” of capitalism, where new, better, more innovative companies displace the old, sluggish ones, doesn’t really apply to the food industry.
There is a global oligopoly with great lobbying power, and they run the show. They will resist disruptive changes to the rules of the game like the oil multinationals, who, to this day, have not produced a drop of oil less then they used to, despite the climate crisis.
If you shout the name of Marx into the forest, you get a revolution somewhere in the world. And maybe that’s exactly what we need. Not necessarily in the sense that we break up corporations and introduce global workers’ and nutrition councils to improve nutritional tables. (Although, why not?)
Industrial food is a plague, you can bet your pancreas on it.
Whatever this revolution looks like can hardly be discussed at the end of this text, but maybe it’s enough to recognize the need for it. In any case, it would also be an internal revolution, one at the end of which no one would believe that being overweight is a question of weakness of will.
Don’t get me wrong, it’s not about not eating fast food anymore. Nobody wants to give up their comfort food. Being able to suck on a soft drink as contentedly as a baby is not only an achievement that makes life somewhat bearable, it is also equally affordable for the entire working class.
But on a global scale, industrial food is a plague, you can bet your pancreas on it. And trusting global food companies to solve the obesity crisis they are responsible for is naive. If Ozempic, and what comes after it, breaks the business model of irresponsibly monetizing our evolutionary cravings for sugar and fat, then it would be a useful tool. And if the revolution succeeds, who knows: We might find ourselves in a world where weight-loss injections are no longer needed at all.
