Customer Consciousness and the GLP-1 Phenomenon
Ask most people in pharma about GLP-1 and you get the same debate, which is some version of how we get into this market. That is a fair question and it is not the more interesting one.
The more interesting question is what comes after GLP-1, and it is not which mechanism follows semaglutide or tirzepatide in the obesity pipeline. It is which human conditions may be accumulating the same forces that made this category inevitable. That question is worth more than any single category entry, and customer consciousness is the discipline built to answer it.
The category looked inevitable only in hindsight
Category formation in this industry tends to get treated as weather. Something arrives, the science aligns with the moment, and a market appears where none existed. The account is comfortable and it is wrong.
None of the underlying evidence was hidden, and some of it had been in plain view for a decade. The prevalence was documented, the failed interventions were catalogued, the workaround spending was visible on every retail shelf, and the cultural reframing of obesity from moral failure to metabolic condition had been underway in public for years.
The reading was available to anyone looking, and two companies looked. Massive markets in pharma do not have to be bolts of lightning. Forces that produce a category are usually present, legible and countable years before the unlock, which means the gap between inevitability and surprise is a strategic problem rather than a matter of luck.
The need was never weight loss
The need was agency over a life condition that had felt intractable, and customers seeking agency behave as consumers. They self recognized, they self funded, they formed communities, and they bypassed clinical infrastructure that had not served them. Each of those behaviors was observable long before the category declared itself.
That behavior is often the signal worth studying. High agency conditions tend to become consumer grade markets, and consumer grade markets demand commercial architecture to match, which is a different proposition from a therapeutic launch into a category that already exists.
A company that read the condition as weight loss built a product strategy, and a company that read it as agency built a market. The difference was rarely ambition or capability, and more often what each organization believed it was looking at.
Two companies read the same context and both were right
Novo Nordisk and Lilly each read the human context of obesity correctly, and each built the clinical credibility, prescribing confidence and commercial architecture that turned an intervention into a category. Their own language has caught up with that reading.
At JPM26, Novo Nordisk chief executive Mike Doustdar told the room the business "acts a lot more as a consumer business than a traditional medication." STAT reported the telehealth partnerships that followed. David Ricks at Lilly had made the same point earlier and more plainly, telling Axios that "we're used to buying consumer goods directly from manufacturers all the time on online websites."
The patient had already moved ahead of both of them. PMLive put it as the end of an assumption, arguing that the patient "is no longer a passive endpoint in a clinical pathway." Both companies acted on a reading the industry could have made collectively and did not.
Customer consciousness is a discipline rather than an instinct
I define customer consciousness as the practice of reading a customer's world deeply enough that what their life is making them need becomes visible before any market has formed around it. The definition matters because it places the work upstream of research rather than inside it. Research can tell you what people say about a category that exists, and this is the capability that tells you a category is forming.
Reading one condition correctly proves the reading is possible, though it does not by itself make the reading repeatable. In the commercial organizations I have worked inside and audited, no function has carried the remit of reading customer context ahead of category formation. There is no standing brief to detect human conditions accumulating toward a market, no cadence on which that detection runs, and no instrument carrying its output into portfolio strategy.
That absence is the strategic problem, and it is larger than any individual category decision. Reading one condition well produces a franchise. Reading any condition well produces a capability, and those are different assets with different half lives.
The Convergence Readiness Model names seven conditions
The instrument I use to make the reading systematic assesses seven conditions: persistent need, normalized burden, identity intensity, cultural readiness, self recognition, scientific unlock and ecosystem potential. Each is observable in public behavior rather than in proprietary data, which is what makes the reading available to any organization willing to run it.
The model applies to any therapeutic adjacency or investment opportunity under consideration, and it is scored rather than debated. Its purpose is not prediction in the forecasting sense. It is locating where a human condition sits on the path to category formation, and how far along that path it has already travelled.
Capital markets call GLP-1 a supercycle. That reading is accurate and almost entirely uninteresting, because it measures the wave without explaining the water. A supercycle is a demand release event rather than a demand creation event, and what releases is customer context that has been accumulating, unread, for decades.
Context debt is the liability of what you encountered and never internalized
Where value leakage measures what an enterprise loses inside a category it already competes in, context debt measures what it never collects because it never read the context that would have created the category. The two are the same discipline applied at opposite ends of the commercial system. One recovers value already earned, and the other locates value never approached.
The proof of context debt is behavioral rather than financial. Customers in a high agency condition will route around an industry that has not met them, and their workarounds are visible long before any analyst records a market. Every one of those workarounds is a receipt for interest the customer has already paid.
An organization carrying context debt can be commercially excellent inside its existing categories and structurally absent from the next one. Those two facts tend to coexist quietly for years, because nothing in a standard commercial review is designed to surface the second.
Customer consciousness sits upstream of everything else in the platform
Pharma reasons from first principles in the laboratory and has largely reasoned by analogy in the marketplace, taking the last launch as the template for the next. The obesity category was won by an approach closer to the first habit than the second. Read the condition people were actually living with, then build the system that would let a credible answer land.
That sequence is repeatable, and repeating it deliberately is worth considerably more than entering the category it produced. It is also the upstream end of the same argument that runs through value leakage and the Realization Rate at the downstream end.
GLP-1 is the masterclass. Customer consciousness is the discipline. The Convergence Readiness Model is the instrument. Customer Excellence is the institution that holds all three, and the companies that build it will not be chasing the next GLP-1.
Key Takeaways
- The forces that made GLP-1 inevitable were documented, visible and countable for years before the category formed. Two companies read them and the rest of the industry treated the result as weather.
- The need was never weight loss. It was agency over an intractable condition, and customers seeking agency behave as consumers and demand consumer grade commercial architecture.
- Customer consciousness is the practice of reading a customer's world deeply enough that what their life is making them need becomes visible before a market forms around it.
- The Convergence Readiness Model assesses seven conditions: persistent need, normalized burden, identity intensity, cultural readiness, self recognition, scientific unlock and ecosystem potential.
- Context debt is what an enterprise never collects because it never read the context that would have created the category, and its proof is behavioral rather than financial.
Diagnostic Questions to Consider
- Which function in our organization carries a standing remit to read human conditions accumulating toward a market, and on what cadence does it run.
- Where are customers in our adjacent conditions already self funding, self organizing or routing around us.
- If we scored three adjacent conditions against the seven convergence conditions today, where would each one sit.
- When we explain a category we missed, do we describe forces we failed to read or circumstances that failed to cooperate.
- What would change in portfolio strategy if customer context were treated as a first principle rather than an input to execution.
Closing Reflection
The industry explains its largest events in language that removes its own agency. A market appeared. The science aligned. Conditions were favorable. That account protects everyone in the room and teaches nobody anything.
Categories have an anatomy. The forces that produced obesity were present and legible years before the unlock, and equivalent forces are present and legible in other conditions today. Reading them is a discipline that can be built, which means the next convergence will be found by whoever happens to be looking closely at the right condition, unless the looking is made systematic.
The full argument, the scored instrument and a worked example are set out in The GLP-1 Masterclass in Customer Consciousness , the third CEA practice paper. It runs the protocol end to end so the technique is demonstrated rather than described.
About the Author
Wayne Simmons is the founder of The Customer Excellence AGENCY and the author of The Customer Excellence Enterprise (Wiley, 2024). He is founding faculty of the MS in Customer Experience Management at Michigan State University's Broad College of Business. He led global customer excellence in Pfizer's first Chief Marketing Organization and in Bayer's Customer Powerhouse.
The Customer Excellence Agency: Advancing the Pursuit of Excellence in Service of Science.
