>Stomach paralysis is apparently a known side effect [1]. There are also lots of anecdotes about lesser (but still foul) digestive surprises that are too unpleasant for me to bother elaborating on here.

These are real, but they're also not permanent, and are why you start on a low dose to evaluate how your body reacts to the medication. My spouse is a long time GLP-1 user (coming up on four years now) and had mild (or more) bouts of several of these digestive related systems.

However, within six months these had greatly diminished. And by the one year mark, even at the highest dose, they were essentially gone and have remained a non-issue since.

You should certainly be mindful of side effects, and follow the recommended dosage scale up, which should be monitored by your doctor.

>I was on my thiccboi swag for the latter half of last year and am presently working it off by rebuilding my fitness base with kettlebells and cardio. I'd rather do this than GLP-1s not because I'm some sort of iron-willed badass so much as I'm simply distrustful of anything that messes with one's metabolism so severely. While these drugs are useful for the morbidly obese and diabetics I simply can't imagine how or why anybody would go on them for aesthetic or off-label purposes.

I do think folks with obesity fall into one of two camps (or somewhere on a spectrum between): those that are in that place because they don't put in any effort, eat whatever they want, don't workout, and so on.

And then there are folks like my spouse. They were able to lose weight in the past, but only through continued suffering. To be "just" overweight, they needed to be working out constantly and in a state of always feeling hungry. They never reached an equilibrium where it wasn't agony to maintain that weight, and after months/years would always rebound.

For them, a GLP-1 was the only thing that ever quieted the food noise. They workout constantly still and are in the best shape of their life. It wasn't entirely the GLP-1, but that gave them the tool to quiet the noise and get to a state where fitness could be fun/sustainable, and now they're killing it.

So, the TL;DR is that some people need this tool, and it's not necessarily an either/or. It can be one part in a series of positive changes that lead to better health and well-being.