> The majority of people who are accessing this drug have endocrine systems that work just fine, but problems with controlling themselves around food.

Citation needed. This is the main assumption you are making that I, and others, vehemently disagree with.

The implication is that this is the first time people have suddenly decided they don’t like being obese. That’s absurd. The people on these medications have tried everything. Talk to literally any obesity doctor and ask them about their patients.

This assumption is the problem. Nothing about the meds is easy. It just makes it possible for people to change when they couldn’t before.

I don’t know why people feel a need to argue against that.

> Our societal-level response is to treat it with a drug rather than helping people who really do have significant willpower problems overcoming their lack of discipline. There are hugely beneficial approaches that rely on CBT, for example, but are relatively controversial because of "weightism" concerns.

Sure, and I don’t disagree. And I’m all for people doing that too. If it works, great!

On average, it doesn’t, for the vast majority of people, though it does work for some, and that’s great. I agree it’s a preferable approach. But if it worked for most people, it would have worked.

But if it doesn’t work? Previously, people just accepted that they were going to be obese and miserable, and that it was their fault, which led to depression, etc., further making it “impossible” to ever fix.

So if there is a medication that helps people change their lifestyle to get healthy, and also appears to be extremely effective, and has a good safety profile… that’s bad?