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They work!*
*aslongasyoudontstop
When you get to a certain size, food is the same as booze to an alcoholic.. these drugs turn off the food noise telling you to eat.. they let your bodies ability to decide when full reset to normal and give you a chance to form good habits without an imaginary food devil in your ear telling you to binge junk food.. with good habits formed managing your now healthy weight at the end of a program of use is easier.
"a chance to form good habits"
And that's the issue right there, without professional support the majority of people who have an unhealthy relationship with their food just fall down the same hole whenever they manage to get out of it, may it be through diet or medications or even surgery.
Dietician training now puts a lot of focus on psychology because of that, giving someone a pill to make them lose weight won't fix the childhood trauma of being abused that causes them to find comfort in food, if they stop the medication that is still there, that's why the long term failure rate of diets is so high, they don't address the why, just the what.
Not everyone overeats due to trauma.. I stress eat and have eat often out of boredom/habit. I've personally tried dieticians and found them to be snake oil salesman( not saying all are but the ones I have tried) who are trying to sell their weight management group programs or are indoctrinated in the ancel keyes food pyramid bullshit. Two things work for me, these drugs and a low carb diet.
If I need services similar to those of a dietician, I'll use an A.I agent.
The dieticians you talked to aren't medical dieticians then, they're people who call themselves dieticians without any university degree. AI will just spew whatever bullshit it was trained on so you'll probably be reassured that what you're doing is ok because it was trained on/r/fitness or whatever instead of scientific papers.
Eating out of boredom is an unhealthy relationship to food, I'm not saying all cases are out of trauma (holy shit lemmings have a hard time when things aren't spelled out for them), I'm saying the underlying issue needs to be fixed to have a permanent solution, you said so yourself, you need the drugs and low carbs diet in order to fix the problem, stop both and the problem comes back.
You didn't fix your leaking roof, you applied a patch and it will start leaking again if you remove it.
Same as for working out, controlling your calorie intake etc.
Bingo, those medications are as effective as any other diet or change of habits, if you have a problematic relationship with food you need to fix the reason behind it otherwise the moment you stop you'll gain your weight back.