> Are these drugs fixing/replacing a system failure where people don't feel satiated normally?
> Can the same effect be replicated by eating a higher fiber and higher fat diet with more whole foods to feel full longer and slow gastric emptying?
I think it simply takes a long time for your body to adjust back to where it should be after a period of extended binging and these drugs make it happen much faster. The only time I consistently lost weight in my life was when I lived in a food desert and had no car and not much money, so I was forced to only buy the cheapest vegetables and meats (usually chicken) and make what I could out of that and make it last for the week. Even then it took more than 6 months before I felt normal eating that way.
Of course, it's extremely easy to fall off the wagon when your body works this way too. Even a day can wipe out weeks of gains and you can always 'relapse' even after months of doing the right thing, and end up stagnating or completely reversing any progress you've made. In a way it seems that food is the most addictive drug of all. You can easily quit alcohol, cigarettes, hard drugs with a couple weeks of willpower (and I have multiple times). You can't ever stop eating food if you want to be around to experience life.
I think it simply takes a long time for your body to adjust back to where it should be after a period of extended binging and these drugs make it happen much faster. The only time I consistently lost weight in my life was when I lived in a food desert and had no car and not much money, so I was forced to only buy the cheapest vegetables and meats (usually chicken) and make what I could out of that and make it last for the week. Even then it took more than 6 months before I felt normal eating that way.
Of course, it's extremely easy to fall off the wagon when your body works this way too. Even a day can wipe out weeks of gains and you can always 'relapse' even after months of doing the right thing, and end up stagnating or completely reversing any progress you've made. In a way it seems that food is the most addictive drug of all. You can easily quit alcohol, cigarettes, hard drugs with a couple weeks of willpower (and I have multiple times). You can't ever stop eating food if you want to be around to experience life.