I have never struggled with weight. Or not in the direction of overweight anyway. When I am full I don't want food. When emotionally upset, I REALLY don't want food. I don't need willpower or a big bowl of kale before every meal.

If someone can live the life I get to have, with a drug, that is awesome. The GLPs have some good side effects, they have been used long enough now that there's increasing evidence they reduce the risk of dementia, heart attack, and stroke (even in diabetics of normal weight, not using it to lose weight) - not all the side effects are bad, and if it is well tolerated it's a reasonable drug to just stay on.

I do agree that lifestyle comes first. And think most people do enjoy a healthy lifestyle if they try it. But I don't think someone should have to do more than I do, just to get to the same place.

This whole conversation reminds me of getting migraine treatment - the doctors would say oh try avoiding food triggers. What food triggers? Every single food, oh and also fasting. Heat, cold, sex, no sex, stress, relaxation , caffeine , no caffeine. The list of migraine triggers was "life".

I got them with my period though, not something I could avoid, and even though I'm sure the doctor was trying to make me feel empowered to do something about it, it always felt like they were blaming me for getting the migraines.

I have had them managed with emergency med imitrex by injection for 30 years, once a month and now less often with menopause plus estrogen and progesterone daily. Would I rather have had to take extreme lifestyle measures just to avoid crippling headaches? No. The drugs worked so much better.

There is no inherent virtue in avoiding drugs. They are tools, in the same toolkit that holds a good diet and physical activity and meditation.