So really it's not doing much other than reducing how hungry someone feels.
Want to lose weight? It's easy. Go keto. For people that are fat, like myself, cutting carbs will, by nature, cut calories and a higher fat/protein diet will make you feel more full and eat less calories.
The problem is a lot of people like myself want to lose weight while still eating fast food and sitting down all day. No pill/injection will change that.
We've started a pre-packaged meal plan. Meals are normally good (only had a couple we didn't like) but we are down a combined 75+ pounds and still doing the pre-packaged meals since we get a decent selection. Now, we do get a TON of chicken, and that is a struggle, but it's a trade off.
As to your last point, agree. There's no magic pill that will let you lose weight without fundamental changes