These drugs modulate your hormones to reduce appetite and cravings for unhealthy foods. When people lose weight the normal way, their endocrine system sends out a “you are starving, eat” hormone response that is extremely difficult to overcome and success requires 100% compliance for the rest of your life.
Success in adjusting diet does not require '100% compliance for the rest of your life'. It requires serious changes yes, but even frequent slips as part of a largely altered diet won't discount it. This perspective - as well as being factually inaccurate - feeds into shame spirals and negative self efficacy. It's also true that virtuous circles can be built on diet and exercise, replacing the endorphin lift provided by sugar / carbohydrate load; and in the longer term homeostasis can be achieved at a healthier weight. It is difficult, but it's absolutely not as impossible as this comment implies.
I think people who think it's "just that simple" have never seriously tried to starve their body. It's truly incredible how far the human brain will go to get food into your mouth when it thinks you're trying to starve it.
