No drug can ever substitute for a permanent lifestyle change.

Permanent lifestyle change is never easy. It would be great if it were a one-time thing that you could be done with, but for most people, it's a constant mental strain for the rest of their lives.

It's not impossible; some people do it. But it's not easy to change how you think about food and your body, especially when you're surrounded by your old habits every day.

Nothing worth having comes easy.

https://davidgoggins.com/book/

https://suereynolds.net/journey-history/

I’m talking about irreversible physiological changes caused by getting fat that don’t reverse after you lose weight. This is what makes keeping weight off after losing a bunch harder than maintaining the same weight if you’ve never been fat to start with. Things like damage in the hippocampus preventing normal leptin signaling. Once you’ve gotten fat, you’re pretty much fucked for life, even if you reverse the behaviors that got you there.

https://www.stephanguyenet.com/thehungrybrain/

That's mostly pseudoscience.

No.

Sci hub up this paper and check out the citations too.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/obr.13270

Yes I've seen that. It's just an opinion, not real science.