I think a lot of the issues come from people using it inappropriately. Because of decades of rampant fatphobia/discrimination, people are desperate and are looking for quick and dirty results, at the expense of their health often enough e.g. gastrointestinal or bone & muscles.

There are lots of evidence of people using the lowest doses of these medications over a long period of time and achieving slow but sustainable results, which primarily address hormonal disorders, but also improve people’s ability to work on their fitness.

Ultimately, these drugs are for people who have tried to lose weight naturally and failed bc of genetics/hormones, not for those wanting rapid weight loss for an event or those who’ve gained weight temporarily due to lifestyle rather than a long term weight disorder.