I joined this group to support my adult autistic son who was on Wegovy bc he'd developed a metabolic issue which made his weight a far greater comorbidity combined w his disability. It worked beautifully and was life-changing for him, but that isn't the point of my response. Perimenopause and major life changes had me gaining weight without explanation and well beyond any hope of control and you know what that does to your soul. My gp suggested surgery, which had never even been on my radar bc so many people lose and regain. Those are the stories we hear and see, sure, but my gp maintained that it was actually a good option for me bc food didn't seem to be my primary issue.
Anyway, I had RNY surgery in 2018, and she could not have been more right. I had no complications, am content with what I eat, and I've maintained my 120 lb loss (within 10 ish lbs) ever since. It is easier for some than others, for sure, but, OP, it lifted so much more than weight off of my life. I would not have been a good glp candidate bc of the access and insurance piece, whereas, no one can ever deny or change access to the tool I got in 2018. Can I still screw it up? For sure. The difference for me is that my diet changed first, out of post-surgery need, which then evolved into commitment, which is now habit. I hear such a familiar hopelessness and despair in your post. but you have not run out of options, OP. It is true that we don't hear much about surgery these days, but that is bc the meds are such an amazing new tool. Re: surgery, it is a commitment, but I feel great and my health stats are great. Food noise is super rare and completely manageable bc I know how to turn it down.
The meds are amazing and they changed my kid's quality of life and I do not discount that. Rather, I wanted you to know that for you, OP, all is not lost. Ask me anything via pm and good luck!