[OrwellianChild]

Not trying to single you out as this has been brought up in multiple comments in-thread, but I think this is apples-to-oranges. Diets work when followed. The problem is that the vast majority of people struggle to adhere to them. This drug aids in reducing the urge to eat, which reduces/eliminates the need for scrutiny over intake. It's "diet autopilot", which is why it's so powerful.

[avgcorrection]

I don't think bringing up keto is terribly on-topic, but my experience with low-carb wasn't like that at all. Most low-carb isn't about miserly “calorie-counting” and willpower. It's about establishing a routine where you can comfortably just not-eat for those windows, which turned out to be easier for me than to stick to my previous eating schedule but eating (say) 20% less.

[asow92]

Both involve weight loss via reducing insulin response and improving insulin resistance. It’s certainly on-topic.

[asow92]

The ends are the same and the means are different. The metabolic actions between the two are similar. It's not an unfair comparison. One might have adverse longterm side effects and the other might not. This is something further study could help answer.

[OrwellianChild]

I mean that the reason you'd need semaglutide is that you can't keep to a diet. If you could keep to keto IF, you wouldn't need the drug in the first place. It's not option A or option B. It's "if A fails, fall back to B".