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I can see how a short-term use of the meds might be life-changing. IF the people use this "break" to create new habits. But of course some people will just eat less junk. This is the first person I've heard of who reports craving real food and while we don't know what that is (could be baked potatoes instead of fried) because he still fears saturated fat.
Because real foods require actual digestion, and so they satisfy.
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The ones I know who are doing the GLP-1 drugs are generally eating real foods. Or at least they started out that way.
But what happens is that they get too busy and run out of time to cook, or get sick and don't have the energy to cook, or end up working overtime for weeks with no time to cook. When that happens, they turn to ordering out, picking up something at a drive thru, or heating up some kind of pre-fab stuff from the store.
They definitely eat less when on those drugs than without the drugs (supplies of the drugs are still limited - sometimes they can't get the dose they need). But they are still definitely not using the time on the drugs to truly rid themselves of their habitual junk foods either, just relying on the drugs to limit the amount they can consume when they eat junk, instead of a carefully planned out meal. There are places where you could get a less junky meal, but the drugs make it so difficult to stomach the idea of certain foods (beef seems to be the one they have the most aversion to eating), so they eat fish/seafood, maybe the rare bit of chicken.
The drugs slow down digestion so much that anything with more than minimal fat content is nearly impossible for them to digest - so if they're eating say for instance breaded popcorn shrimp, they might only be able to eat a couple of them without it making them sick, because of the amount of oils absorbed by the breading on the shrimp.
I don't know why they don't pick the breading off of the fish/seafood to avoid the indigestible fat and just eat the shrimp. Or why they don't combine the innards of a sandwich on one slice of bread - to me those would be the logical things to do, so that you get the parts of the meal which have actual nutritional value. But they don't - if it doesn't come served without the stuff that fills you up quickly (big crusty sub roll instead of wrapped in lettuce leaves) or that they can't digest (deep fried breading on seafood instead of steamed), they just eat less of the entire meal.
I think it must come down to what they perceive as normalcy - I'd probably embarrass them to death, leaving behind pizza crusts after eating only the toppings, or picking the breading off shrimp, or tossing the sub roll and eating the innards instead.