My understanding is taking sugars/carbs off is good because they don’t seem to count towards the body’s “I’m full!” detection, unlike actual fat, despite being highly caloric and easily metabolized. If you’re eating till you’re full, fat is better, because you’ll be full sooner.
But yeah intuitively I can see how that wouldn’t do so much if the internal fat control system is fucked up to a point that you’re never full. (Though I’d assume that metabolization rates still matter? IDK I’m no dietetician).
Hopefully we can get some progress on the science side of things now that academic views on obesity are finally shifting. The medications in the OP also sound interesting, if they actually reduce the source of the problem (the cravings), but that’s a discussion to be had with your GP, not an unqualified internet stranger.