I haven't seen this thread before because I don't come to Surly as regularly as I used to... but...
My personal story is that my doctor started me on Mounjaro last June and in the last 11 months I have lost 85 lbs.
I am 6-5 and have always been "big" but it was starting to get out of control as I got older and got further away from my football career. Was up to 360 and the doctor said I needed to do something about it. My goal is to get down to below 260, so I have another ~20 lbs to go.
In my late 20's after I was done with football I went on a big fitness kick and got down to 220 at one point and that was less than 10% body fat and very difficult to live with, so the doctor thinks "somewhere in the 250's" is a good place for me to be - somewhere just under 20% body fat - hence my goal.
Have never been diabetic, so this has solely been for weight loss. The main issue was my blood pressure with the increasing weight. Now my doctor thinks I can get off the blood pressure medicine within the next month or so.
As far as the cost, I am self-employed and have shitty health insurance, so this has been entirely out of pocket. $720 per month at Costco and entirely worth every penny. Luckily the money isn't an issue for me personally so I don't care if I take it for the rest of my life.
As far as the "secret", I lost weight as soon as I started on it, but the real secret, at least for me, is that I was able to regularly start fasting rather easily. Then the weight really started falling off. I now eat only between 4:00 and 8:00 most days, with a snack and then however big a dinner I want, which usually isn't very big because I get full easily. I also am able to completely fast 1-2 days per week and just don't eat at all for 36-48 hours.
The drug also has some anti-inflammatory properties, so combine that with the weight loss and all of my old knee and shoulder pain has mostly gone away, too.
It's a miracle of modern medicine.