> when the only affect is appetite suppression

You don't know this.

> These things are useful for a few months

You don't know this.

> For anyone else (most people), it's much healthier to learn how to do difficult things.

You don't know this.

> Willpower is a muscle.

I know you mean this in a figurative sense, but what exactly is "willpower"? There has to be a physical (and physiological) mechanism for "willpower", no?

Do you believe that can be aberrant physiological conditions?

I do. I also believe over-eating is a manifestation of some type of "aberrant" physiology.