Part 2. Who Are We Now?
(Ethics and Anthropology)
2.1. Pharmakon, or The Soul for Sale

Hack: 6 November 2025, Washington, The White House

Gordon Findley, a top executive of Novo Nordisk, the manufacturer of Ozempic, standing behind US President Donald Trump during an event with drug manufacturers in the Oval Office, lost consciousness. The broadcast was carried by Fox News, whose journalists identified him as an employee of the company.
Officials had to interrupt the event to assist the man. "Gordon, are you alright?" asked David Ricks, the head of Eli Lilly. After the man collapsed, Trump rose from his seat at the table. A doctor rushed to help the unconscious man.
Also present in the Oval Office was Secretary of Health and Human Services Robert F. Kennedy Jr.
White House Press Secretary Caroline Levitt stated that the pharmaceutical executive who fainted was "doing fine" (RBC News).
Irony worthy of a Greek tragedy: the head of a pharmaceutical giant whose drug is redefining the boundaries of the human body finds himself defenceless before his own body. His collapse becomes a symbol of a far larger collapse — the breakdown of the old world, where the body was "natural" and the drug merely a means of repairing it.
The story of semaglutide, the active ingredient of Ozempic and Wegovy, began within the framework of ordinary pharmaceutical development. Synthesised as a GLP-1 receptor agonist, it mimics the action of incretins — hormones secreted by the gut in response to food intake — stimulating insulin release and suppressing glucagon secretion. The mechanism of action, therefore, was strictly oriented toward the correction of metabolic disorders in type 2 diabetes.
However, during phase III clinical trials, an effect beyond the therapeutic profile was recorded: patients demonstrated sustained and clinically significant weight loss. Further research revealed that semaglutide acts on the hypothalamic centres of appetite regulation, modulating the neural circuits responsible for the formation of hunger and satiety. In essence, the drug did not "burn" fat or accelerate metabolism — it reprogrammed desire.
The commercial consequences of this discovery are well known. Novo Nordisk, having patented higher dosages for obesity therapy, entered a phase of exponential growth. Data from Statistics Denmark for the third quarter of 2025 register an anomaly: Danish GDP growth of 2.3% with zero contribution from non-pharmaceutical sectors. Eliminating the pharmaceutical component reduces the figure to 0.7% (Danmarks Statistik, 2025). In other words, nearly all the economic growth of a developed European economy was supplied by a single company and a single class of drugs. Novo Nordisk's share of Danish exports reached 40%, its market capitalisation exceeded the country's nominal GDP, and its contribution to GDP is estimated at 5-6.7% (OECD, 2026).
But for philosophical analysis, what is essential is not so much that one company dominates the national economy, but the nature of this domination. Denmark's welfare has been rendered dependent not on industrial production, not on natural resources, not on technological leadership in the traditional sense, but on a patent monopoly over a molecule that modulates human desire.

Desire as an Anthropological Constant

The pharmacological modulation of appetite poses a question that the philosophical tradition from antiquity to psychoanalysis considered fundamental to the understanding of the human — the question of the nature of desire.
All of Western metaphysics of the subject was constructed around the thesis of the constitutive nature of desire. Plato, in the Republic, carrying out the first systematic topography of the soul, distinguishes the appetitive part as an autonomous source of psychic energy, irreducible either to reason or to spirit. Appetite is not merely one function among others but a fundamental layer of the human being, with which reason enters into a relation of governance, but not of creation (Plato, 1997: 439d-441c). Aristotle, in De Anima, conceptualises desire as the connecting link between cognition and movement: desire is what sets a living being into action, being intentionally directed toward an object conceived as a good (Aristotle, 1931: 433a-433b). Without desire, consequently, there is not only no action but also no life as actualisation.
Christian anthropology, inheriting Hellenistic psychology, places desire at the centre of the drama of the Fall and salvation. Augustine, radicalising the Apostle Paul, sees in concupiscentia not merely an affect but an ontological trace of original sin — a distortion of the will that turns man away from God, yet remains an inalienable dimension of his subjectivity (Augustine, 1998). Desire — even when sinful — is my desire, the field of my struggle and my salvation.
Early modern philosophy, beginning with Descartes, secularises this intuition but preserves its structure. Descartes includes desire among the six fundamental passions of the soul, defining it as "an agitation of the soul caused by the spirits that disposes the soul to will for the future the things which it represents to itself as agreeable" (Descartes, 1989: 512). Here desire retains intentionality — it is always directed toward something represented as good — and belonging to the subject as a mode of his existence.
Freudian psychoanalysis effects what seems a radical rupture, placing desire in the unconscious. Yet the structure of belonging remains: unconscious desire is precisely my desire, albeit repressed, distorted by censorship, sublimated into culture. Psychoanalytic therapy is nothing other than the work of the subject's appropriation of his own desire, the return of what was alienated (Freud, 1961). Desire remains the inalienable core of subjectivity, even when inaccessible to immediate reflection.
Across all these conceptions, for all their metaphysical and methodological differences, one fundamental intuition is preserved: desire belongs to the subject. It may be sinful or virtuous, conscious or unconscious, governable or ungovernable — but it is a mode of my existence. One may enter into relations with it (struggle, knowledge, sublimation, acceptance), but these relations always remain relations within the subject, between different instances of his psychic apparatus.
Semaglutide and its analogues introduce a radical rupture into this two-thousand-year-old tradition. The specificity of this rupture must be rigorously conceptualised, avoiding both moral panic and technological apologetics.
The key distinction runs not along the line of "natural/artificial" (that opposition has long been deconstructed), but along the mode of the absence of desire. In classical strategies, desire is suppressed, overcome, sublimated, accepted — but it is present as that with which the subject enters into relation. Asceticism, psychoanalysis, diet, ethics — all are forms of working with desire, presupposing its presence.
Semaglutide acts in a fundamentally different manner. It does not block desire by an effort of will, does not redirect it psychoanalytically, does not sublimate it culturally. It turns off the signal. Desire is eliminated at a pre-subjective, neurophysiological level, where the intentional act has not yet been formed.
The phenomenological structure of this process can be described as follows. Normally, desire is experienced as an intentional state: I want X. Even if X is absent or unattainable, desire itself is present as a mode of consciousness — as directedness, as attraction, as lack. Hunger — even when physiologically determined — is phenomenologically precisely a directedness toward food, an intentional act constituting the object.
Pharmacological modulation eliminates neither the object nor the relation to the object. It eliminates the very mode of intentionality. In the limit: I do not choose not to want — I simply do not want. Desire disappears not as a result of a subjective act (decision, refusal, overcoming) but as a result of an objective intervention into the physiological mechanisms of its generation.
A situation arises that can be called existential anomie or ontological deficit. All the categories with which the philosophical tradition described the human being's relation to his own desires — struggle, sublimation, acceptance, refusal — prove inapplicable.

Freedom and Its Negation

This shift calls into question the category that the philosophical tradition considered fundamental to the understanding of human action — the category of freedom. To sharpen the point polemically: the pharmacological modulation of desire requires a revision of the very concept of autonomy.
Aristotle, in the Nicomachean Ethics, laying the foundations of European ethics, distinguishes between voluntary and involuntary actions but posits at the basis of moral action conscious choice — "a deliberate desire for things within our power, after deliberation concerning what leads to the end" (Aristotle, 1985: 1113a 10-12). Freedom, for Aristotle, is realised in the space between desire and reason, where I can choose how to act upon my desires.
Radicalises this intuition, making the autonomy of the will the condition of possibility of morality as such. "Autonomy of the will is the property of the will by which it is a law to itself (independently of any property of the objects of volition)" (Kant, 1998: 284). The free will is a will that gives the law to itself, not receiving it from outside — neither from nature, nor from society, nor from God. The moral subject is one who himself determines the maxim of his action.
Existentialism, from Heidegger to Sartre, makes choice the fundamental mode of human existence. "Man is freedom," Sartre formulates (Sartre, 2007: 78). We cannot not choose; even the refusal to choose is a choice. Freedom is not a property of the human being among other properties, but the mode of his being, his ontological structure.
In all these conceptions — for all their differences in understanding the foundations and limits of freedom — freedom is thought of as an internal affair of the human being. Even if external circumstances limit the possibilities of action, even if the unconscious governs us, even if God foresees everything — the decision, the choice, the act of will remain ours. They may be conditioned, determined, limited — but they belong to us as subjects.
The pharmacological modulation of desire undermines the very possibility of such appropriation. Let us pose the question rigorously: what happens to choice when desire is eliminated chemically? If I "choose" healthy food, but this choice is ensured not by my decision (however conditioned by unconscious factors) but by the direct action of semaglutide on the arcuate nucleus of the hypothalamus, suppressing the secretion of neuropeptide Y — in what sense is this my choice?
An opponent might object: I freely chose to take the drug, knowing its effects. This objection captures an important point, but does not resolve the aporia, merely complicates its structure. It creates a configuration that can be called second-order autonomy or meta-autonomy.
I freely choose to take the drug. In this primary act of choice, I realise my autonomy — I make a decision based on reflection, weighing consequences, relating to values. But the result of this choice is that in each subsequent concrete act of food behaviour, I no longer choose; my desire is produced pharmacologically, my intentionality is suspended by neurochemistry. Here freedom is realised as the right to self-elimination, to the transfer of control to an agent that is not a subject — the pharmacological mechanism.
The point, however, is not the disappearance of the subject. Rather, the subject shifts: decision is transferred from the level of individual acts to the level of the architecture of conditions. We no longer choose between wanting and not wanting — we choose the configuration in which desire will be produced.
This structure does not fit into Kantian autonomy, where the will gives the law to itself in each act. Neither does it fit into the existentialist project, where the subject chooses himself in each situation. This is a new configuration, in which freedom and its negation are inextricably intertwined, forming what can be called the aporia of the pharmacological subject.
It is appropriate here to turn to Kierkegaard, who in The Sickness unto Death analyses despair as the impossibility of being oneself. Kierkegaard distinguishes between "the despair of not willing to be oneself" and "the despair of willing to be oneself" (Kierkegaard, 1989). In the case of pharmacological modulation, a third figure arises, not foreseen by the Danish thinker: the despair of willing not to will. Freedom directed toward its own abolition. Autonomy realising itself as heteronomy.

The Body Between Givenness and Project

The pharmacological modulation of desire redefines not only the structure of freedom but also the very understanding of corporeality. This aspect requires conceptualisation beyond both naturalistic physiology and phenomenological descriptiveness.
The phenomenological tradition — from Husserl through Merleau-Ponty to the late Sartre — insisted on the distinction between the body-as-object and the lived body. Merleau-Ponty, in the Phenomenology of Perception, introduces the distinction between the "body-object" — the body studied by anatomy and physiology — and the "phenomenal body" — the body as it is lived, as the point of reference for all experience, as the condition of possibility of perception (Merleau-Ponty, 1962). My body in the phenomenological sense is not what I have but what I am.
Sartre, in Being and Nothingness, develops this intuition in an ontological key, showing that the body is "the form of contingency which I must assume in order to be" (Sartre, 1956: 324). The body is a fact with which I cannot but reckon, but which I can never fully appropriate. It is both mine and not mine simultaneously — the point of irresolvable contradiction between the transcendence of consciousness and the facticity of existence.
Foucault, in his late works, shifts the focus from the phenomenology of experience to the analysis of the production of corporeality by power and discursive practices. The body is not a given nor an experience but the result of "disciplinary technologies" that shape it, optimise it, subject it to certain norms (Foucault, 1995). Biopower produces the bodies it needs.
Semaglutide introduces a fundamentally new dimension into this conversation. It does not discipline the body in the Foucauldian sense — discipline requires the active participation of the subject, the internalisation of norms, self-control. It does not produce the body discursively — discourse remains in the realm of meaning and representation. It modifies the functioning of the body directly, at a pre-discursive, pre-subjective level, bypassing both consciousness and disciplinary practices.
The question arises: what happens to the lived body when its desires are produced pharmacologically, without the participation of intentionality? Does it cease to be "mine"? Or, on the contrary, does it become "even more mine", since I finally gain control over what was previously beyond my power?
Neither answer is satisfactory. The first leads to the alienation of the body — yet the body continues to be experienced as mine. The second leads to the illusion of absolute control — yet this control is delegated to an external agent. The aporia is not resolved but requires the introduction of a new category.
We propose the category of the body-as-project. A project is neither substance (something that is by itself), nor mode (a mode of being of something else), nor relation. A project is a configuration existing in a mode of constant maintenance, constant reconfiguration, constant renegotiation of boundaries. The body-as-project is a body that is not given but made. And made not once (as in a surgical intervention or tattoo) but constantly, in each act of maintaining the effect.
Semaglutide must be taken regularly. The effect lasts as long as the pharmacological action lasts. Discontinuation returns the body to its "original" state — or, more precisely, to the state that would exist if the intervention had not occurred. The body-as-project requires constant effort of holding. It exists as long as it is maintained. As soon as maintenance ceases, it returns to its original state or to a state of decay.
This is a radically different temporality from that to which Western anthropology is accustomed. The "natural" body lives, develops, ages, dies. It has an internal temporality, independent of the subject's decisions. The body-as-project exists in a mode determined by external factors — injection frequency, duration of patent action, drug availability. Its temporality is the temporality of a technical device, not of an organism.
In this sense, the body modified by semaglutide turns out to be structurally isomorphic to those forms of existence we discussed in previous chapters: ChatGPT's utterances, existing only in the mode of generation, and antihydrogen, existing only in the mode of holding. The common feature is ontological dependence on external conditions of maintenance.

Biopolitics of Modulation

The pharmacological modulation of desire creates not only anthropological but also political divisions, requiring analysis in terms of biopolitics. The difference in drug price across different national jurisdictions is not an empirical detail but an indicator of deep ontological stratification.
Foucault, in his lectures on The Birth of Biopolitics, analyses how liberal governmentality governs not so much territories and subjects as the life of the population — processes of birth, death, morbidity. Health becomes an object of political rationalisation, the population becomes a field for the application of technologies of power (Foucault, 2008).
Agamben, in his works on "bare life," radicalises this analysis, showing how sovereign power produces the fundamental distinction between politically significant life and mere biological existence. One and the same body may be included in the political community or excluded from it, reduced to pure biological fact, stripped of political dimension (Agamben, 1998).
Semaglutide creates a new dimension of this distinction, not reducible either to classical biopolitics of population or to sovereign exception. Access to the modulation of the body becomes a new type of biopolitical boundary — a boundary running not between the included and the excluded, but between different regimes of corporeality.
Those who can pay (or whose insurance systems cover the drug) gain access to a different regime of corporeality — a regime in which desire can be turned off, weight normalised, the body optimised in accordance with medical and aesthetic norms. Those who cannot remain in the regime of the "natural" body, condemned to struggle with their own biology, to the effort of diets and self-control.
What emerges is what can be called ontological inequality. It is not reducible to differences in income (though expressed through it), to access to education (though correlated with it), to quality of healthcare (though including it). It is a difference in the very modes of existence. The rich and the poor, the insured and the uninsured, those living in different healthcare systems — live in different bodies, not metaphorically but literally. Their corporeality functions differently, their desires are produced differently, their relation to their own body is structurally different.
Esposito, in his works on biopolitics, shows how the logic of immunisation — the protection of life through the creation of barriers — paradoxically turns into the negation of life. Protecting the life of some, we exclude others from the common space (Esposito, 2008). The pharmacological modulation of desire operates according to a similar logic: giving some control over their biology, optimising their bodies according to dominant norms, it excludes others from the space where such control is possible, condemning them to unmodulated, "natural" corporeality, which is increasingly perceived as deficient.
The key characteristic of the situation under analysis is its principled temporariness, its temporality, its dependence on legal and economic parameters. The patent on semaglutide expires in 2026. After that, generic production will begin, Novo Nordisk's super-profits will be reduced, and drug accessibility will be expanded.
The patent in this configuration functions not merely as a legal instrument of market regulation but as an ontological boundary. It determines the regime of existence not only of the drug itself as a chemical compound but also of those modifications of subjectivity that this drug produces.
As long as the patent is in effect, a certain mode of existence (the body without hunger, desire without suffering, weight without struggle) is accessible only to those who can pay the monopoly price. This creates a temporary ontological stratification: for a certain period, some live in a modulated body, others in the "natural" body. After patent expiry, the boundary shifts but does not disappear — it is redefined by market mechanisms of another type (competition among generic producers, inclusion in insurance systems, residual price).
This structure exposes a fundamental feature of produced subjectivity: its ontological dependence on external, non-subjective factors. Unlike "natural" characteristics, which are thought of as constant (at least relatively), produced characteristics exist in a mode determined by legal, economic, and technological parameters that may change — and do change — independently of the subject's will.
My body, modified by semaglutide, is not "mine" in the same sense as my body before modification. It is the result of a complex network including patent law, market mechanisms, corporate decisions, physicians' actions, healthcare policy. Change any element of this network — and my body changes. Patent expiry, drug prohibition, change in insurance policy, producer's decision — all of this directly changes my body, without asking my consent.
This raises a question that cannot be avoided: what does it mean "to be oneself" in such a configuration? If my identity, my self-perception, my body depend on a patent that may expire, on a decision of a pharmaceutical company's board of directors, on the outcome of a lawsuit over patent rights — in what sense is this my identity?

From Anthropology of Substance to Politics of Project

For millennia, philosophy asked the question: "What is the human being?" The answers varied — rational animal, image of God, ensemble of social relations, existence, desiring body — but all presupposed that there is some human nature that can be described, defended, realised, or, in the critical version, unmasked as an ideological construction.
The situation with semaglutide demonstrates that the category of "human nature" no longer works as a descriptive and normative framework. Not because the human being has become a "post-human" in the fantastic sense of transhumanist manifestos, but because the boundary between the "given" and the "produced" runs not between the human being and the world, not between nature and culture, but inside the human being itself, cutting through what was formerly thought of as a unity.
This raises a question to which there is no ready answer and which cannot be resolved by an appeal to tradition: how to think the human being in the mode of project?
The old strategy of defending the "natural" is a conceptual dead end. The "natural" is no longer given as a starting point, as a substrate, as a norm. It is always already — processed, optimised, modulated, modified. Even the refusal of modification is a choice in favour of a certain regime of corporeality, not a return to pre-technical innocence.
But from the fact that the "natural" is not given, it does not follow that there is no choice. Choice exists — but it is a choice not between the "natural" and the "artificial" (this opposition has lost its descriptive power), but between different regimes of the production of the human.
We can produce the human being as a resource — optimised, docile, predictable, conforming to external norms of efficiency. We can produce as a consumer — eternally hungry, eternally dissatisfied, eternally desiring the next commodity. We can produce as a project — open, experimental, reflexive, taking responsibility for its own production.
Pharmacology here is neither enemy nor friend. It is an instrument. An instrument that can serve different ends, be embedded in different politics, produce different configurations of the human. The question is not whether to use or not to use pharmacological modulation. The question is who and how determines the ends of this use, who controls the instruments, who has access to the different modes of producing oneself.
The story of semaglutide exposes the structure that will be systematically unfolded in the subsequent treatise: the "human being" is no longer given but produced — and produced through the interaction of heterogeneous forces in permanent conflict. No instance — neither the state, nor the market, nor science, nor ethics — possesses a monopoly on the definition of what the human being is and what it should become.
In this production, there is always tension.
Tension between the will to order — to fix what the human being is, where the boundaries of permissible intervention lie, which modifications are legitimate — and the force of dissolution — the body's capacity to transform itself, to escape fixation, to produce new desires, to resist normalisation.
Tension between the corporation seeking to maximise profit and extend its patent monopoly, and society demanding accessibility and justice.
Tension between the "natural" as an ideological construct and the "optimised" as a technological project.
If we employ the ontological schema introduced earlier, we can put it this way: matter provides possibility, pharmacology fixes order, and life arises in the tension between these fixations and their dissolution. The body-as-project is not a stable form but a trace on a medium, which holds only as long as the forces of holding are at work. The human being here is not a substance but a process of maintaining a configuration. Not an essence but a regime. Not a nature but a constantly renewed imprint.