I don't know to what extent this kind of perspective matters compared to the obviously more common usage of obese people with serious diet control problems, but I come at this more from a physique sport angle. I have no real interest in getting big and don't want to use steroids, so I don't actually compete, but I do lift nearly every day, run nearly every day, and have become extremely lean, probably currently somewhere in the area of 6-7%. My experience of using this myself and of seeing other people use it is from this perspective, people who were never all that fat to begin with and are just looking for it to be easier to be extremely not fat.
And in those communities and in my personal experience, this kind of thing virtually never happens. I've been in a calorie deficit since roughly mid May at this point, and have felt no nausea, haven't vomited, have felt nothing, really. I can barely tell I'm taking a drug. The only perceivable effect is I'm not hungry, and this seems to be the common takeaway from bodybuilders and models and what not doing this. My wife has been taking it for over a year and a half now and has had no side effects.
But I'm not out there trying to maintain my pizza and ice cream diet while outsourcing portion control to a drug. I'm also not trying to lose 80 pounds in a year. I don't eat out, weigh and measure and plan all of my food, and haven't had a dessert or a drop of alcohol since last Christmas. Likely won't have another until this Christmas.
It's just something to keep in mind depending on your specific goals. I feel like, at least until I stopped reading the news, I was getting bombarded almost daily with scare articles like this claiming you'll be miserable, sick, your face will sag and age prematurely, all kinds of ridiculous shit. I can't speak to what it's like to have lifelong problems with food habits and to be over a hundred pounds past the recommended BMI range, or what any means of changing that will do to you. But if you are a reasonably fit person who wants to be absolutely shredded, or someone who has been and can be shredded and has lost weight plenty of times before, but just want it to not be a miserable four months, these drugs are absolute gold. Not just bodybuilders, but dancers, gymnasts, climbers, weight class fighter, anyone with a strong incentive to be very lean most of the time. Maybe we don't matter as much to public health compared to fighting the obesity epidemic, and maybe we're not very common on a place like Hacker News where most readers are probably sedentary and have never been athletes, but we're still a demographic and the GLP-1 revolution has been a godsend for us. They're far safer than anything that existed previously. They just take what you were already doing and put it in easy mode.