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The problem is appetite control is not something you can simply will yourself to have. Being hungry all the time is pretty awful. I'm not saying this is a good alternative, but the whole "just stop eating so much" sounds a hell of a lot easier than it is for many people.
As someone trying to get insurance to pay for one of these drugs, you've pretty much listed the reason. I spent so long trying to find a pattern but have given up, going back to my childhood I've never felt satiated. I never feel full, so I have to rely on other cues. I can eat a huge meal, of any variety, and I'll still feel hungry after (and during). The only modes my appetite has are "hungry" and "if you don't eat you'll die". I've had various meds "help" in one way or the other but none lasted, and none have changed the sensation of hunger. The thought of not feeling hungry makes me want to cry, it sounds so surreal.
You might want to check into Sequence:
https://www.joinsequence.com/
They work with doctors and insurance companies. I'm not associated with them, FYI.
Exactly. To make a comparison, it's like telling a person with depression to just stop feeling sad.
There are other problems. Margaret Cho has talked about how the "just don't eat" thing being told to her constantly while she was on a TV show eventually caused her to have an eating disorder which basically destroyed her kidneys. When she finally got over being hungry all the time, she had an eating disorder.
This is also true. Nothing good ever comes from body shaming, and I mean nothing.
That's why you can't fix the problem without exercise.
You can justify eating more when you're burning more calories.
When I burn 4000 or 5000 calories in a day, I can eat an unlimited amount of food, and often don't make up the deficit. So, it becomes all-you-can-eat with weight loss.
Also, it's important to note that "being hungry all the time" is a symptom of poor eating habits and undernutrition. A lesson in how to eat is going to help someone more than pills.
I think the credibility of the argument that "it's not easy to just lose weight" goes down when the contenders for solutions are "more pills" vs. "Lifestyle change".
Its always better to try the non-pill option before deciding the pills are needed. American policies and support structures need massive overall. Even things that seem totally unrelated like more mixed use and walkable city Zoning policies will make Americans more active and less dependent on meds.
But just saying 'lifestyle change' as if it's some simple thing is the problem. You wouldn't tell a heroin addict to just stop taking heroin. A lot of people are addicted to eating (psychologically, not physically), which is why they feel hungry all the time. Just expecting them to change that like it isn't an addiction is not the way to do it and trying to shame them into it is certainly not the way to do it. There has to be a way to get people to make those changes in a way that eases them out of the addiction. And, of course, like any other addiction, they have to want to change.
Recovering from an addiction is not easy it's one of the hardest things, but it's not impossible.
"No, I don't want to stop eating just give me the magic pills".
I never said it was impossible and I specifically said I didn't think the medications were the way to do it, so I'm not sure what the point of your response is.