There were major weight related health complications I was having at 34 BMI and they're not happening now. I knew how to lose weight -- meticulously track every calorie, use diet and exercise to hit targets. I had done it before , down to -10% and -25% body mass twice in the past ten years. But it never stayed that way -- I found it incredibly hard to stick to my kcal in goal or to stay at a stable lower weight. I'd eat when I was hungry, and eat enough to stay at my long term stable weight. If I ever stopped tracking every calorie in, my default sense of "full" tended towards a caloric surplus.
This drug fills exactly the gap I was struggling to fill with previous attempts at weight loss. I've felt "full" at 1500 kcal/day for months (though have had more of an appetite in the past 1-2 months) and have ended almost every day with a caloric deficit. It's a serious pharmaceutical intervention and I read the literature on GLP-1 agonists for years before starting. There were side effects, notably reflux when eating too much, "sulfur burps", and a general feeling of malaise for the day after taking a dose for the first few months.
No idea what the long term consequences of staying on this drug forever will be. Haven't noticed any other behavior changes. Not particularly interested in the appearance angle (I felt like I looked okay before and look okay now, though I've needed new clothes due to dramatic changes in waist size).
But the health stuff is serious and real and if we can make this drug cheaply available to people who discuss it carefully with a doctor there is potential for a serious chronic disorder to be addressed much more effectively than it used to be.