As someone trying to get insurance to pay for one of these drugs, you’ve pretty much listed the reason. I spent so long trying to find a pattern but have given up, going back to my childhood I’ve never felt satiated. I never feel full, so I have to rely on other cues. I can eat a huge meal, of any variety, and I’ll still feel hungry after (and during). The only modes my appetite has are “hungry” and “if you don’t eat you’ll die”. I’ve had various meds “help” in one way or the other but none lasted, and none have changed the sensation of hunger. The thought of not feeling hungry makes me want to cry, it sounds so surreal.