I think I know this feeling well.

At the end of 2023 and the beginning of 2024, I lost about 60lbs, and it was a basic calorie counting thing. For me, it wasn't too hard; I was able to get used to the hunger and after about a month the feeling of wanting to eat all the time was somewhat tolerable.

In May of 2024, I started taking Pristiq, and one of the side effects is a huge increase in appetite. Like you said, I would feel "full" in the sense that my stomach wouldn't fit anymore matter, but I was always hungry and pretty much perpetually craving sweets. I would get a whole large pizza for lunch, a large meal at Popeyes for dinner, and chase it down with snack cakes, and I would still be "hungry" the entire time.

I managed to undo all the progress I had made with my dieting and a bit extra, and it was kind of weird. It's not really "hard" to know what to do. Obviously everyone knows to eat less processed food, focus more on protein and fiber, etc, but despite me "knowing" this, it was strangely hard to actually do it.

I'm very thankful that I found out about Metformin. I'm not diabetic and never have been, but it's prescribed off-label for weight loss, and according to my doctor it can be useful in the particular case of "canceling out the appetite-increase from medication", and to my surprise it worked shockingly well. I'm still not quite down to my diet weight yet, but I'm down about 30lbs in the four months I've been taking it, and I don't really feel hungry all the time. I still enjoy eating unhealthy food, but food is considerably more transactional now: I eat food because I need energy to survive. I budget about 200 calories lower than what my smartwatch says I burn during the day. It's much easier to treat food as a more utilitarian necessity.

If anyone here is in the unfortunately situation of not having their insurance covering GLP-1 medication, I highly recommend seeing if you can get your doctor to prescribe metformin. It's been out of patent for decades and cost on the order of ~$5 a month [2] and there are very few side effects [2], so it's a relatively low-risk experiment.

[1] Not a referral link https://pharmacy.amazon.com/Metformin-Generic-Glucophage-Ext...

[2] And potential benefits apparently! https://www.health.harvard.edu/blog/is-metformin-a-wonder-dr...