People make such a moral crusade of this - the drug works, people will take it. Behavior modification works in theory and fails for most in practice. Even for those that can make it work usually don’t hold out indefinitely.
We likely agree that doing it without drugs is probably better, but it’s definitely harder and it’s not clear yet how much better it will even be.
I’ve successfully lost 70lbs (250->180) three times and gotten fit, but it’s a constant effort and psychic drain to maintain the lower weight. If the drug (which I haven’t taken yet) made it easy that’d be a relief. It’s much easier to just manage exercise.
I suspect people that don’t have as much difficulty just get a different amount of joy from eating. For me I felt I could relate to the way an alcoholic described trying to quit drinking, except it’s harder in a way because you have to eat.