Excess body weight afflicts more than two-thirds of Americans. Until recently, pharmacological interventions have been incremental at best. In 2021, the FDA approved Wegovy (semaglutide) for chronic weight management, delivering the first results even remotely comparable to bariatric surgery. Herein, we detail the growing weight loss drug pipeline, strategies manufacturers are utilizing to expand access, as well as the impact that greater pharmacological options have on provider services. Obesity specialists may be in a unique position, being more knowledgeable with navigating insurance coverage, at the intersection of manufacturer hub services. Virtual care companies providing access to weight loss drugs are also coming into their own as the pipeline and market expands. Finally, the associated impact of significant weight loss on appearance may drive further involvement of ancillary services in the broader medspa and aesthetic services market.