> Many people taking these kind of drugs are gambling with their well being. No doubt that in many cases that gamble is worth it.
You use the word "gamble" and it is correct, but the connotation is a negative one.
We take a risk in everything we do. We seldom know the long term effects of anything. Right now I drink tea, and I drink tea quite often. Is this healthy? Does it have long term negative effects?
With GLP-1 medications, deciding to not take one, if you are overweight, is also a gamble. A pretty huge one. Obesity very often leads to type-2 diabetes, and the first step is prediabetes. Should someone with high BMI and high A1C avoid GLP-1 because we don't yet know the long term effects? We do know the long term effects of being overweight.
No, it's really not "pretty likely." These drugs are extremely well studied, have been for a long time across now hundreds of thousands of clinical trial participants over decades.
The downsides of obesity however are immense. Far, far worse than people intuit.
Agreed non-pharmaceutical interventions are preferable when they work. But it turns out – empirically – that it's very hard to implement these successfully.
Many people taking these kind of drugs are gambling with their well being. No doubt that in many cases that gamble is worth it.
But issues that can be solved with non-pharmaceutical solutions, such as with weight loss and lifestyle changes, are really better solved that way if possible. There's no risk of longterm effects and it helps foster a larger culture of healthy living in society generally, reducing the lilihood of the problem in the general population.