The Mediterranean diet is commonly framed as a healthy eating pattern, yet it also constitutes a complex food system shaped by local agriculture, biodiversity, short supply chains, and deeply rooted social and cultural practices. Embedded in territorial knowledge and collective food traditions, it links consumption, production, and environmental sustainability across the Mediterranean region. Concurrently, the global surge in obesity and metabolic disorders has accelerated the adoption of pharmaceutical interventions, particularly glucagon-like peptide-1 (GLP-1) receptor agonists. These drugs, increasingly used for weight loss, modify food demand primarily through physiological appetite suppression rather than structural changes in diets or food environments. This paper examines how the rapid diffusion of GLP-1 therapies is reshaping food systems by altering consumption patterns, agri-food markets, agricultural production incentives, and cultural food practices. While recognizing their potential public-health benefits, the analysis highlights risks of decoupling nutrition from food systems, with implications for sustainability, rural livelihoods, and food heritage. The paper argues for an integrated food-systems perspective that situates pharmaceutical innovation within broader strategies for sustainable, culturally grounded, and resilient diets.
