I personally found that it seemed to globally lower any kind of reward-seeking behavior - initially it was alcohol (didn't make a dramatic difference for food), but pretty quickly I quit the running habit I'd had for years. My resting heart rate shot up, my heart rate variability plumetted, and a couple months in I stopped feeling motivated to get out of bed in the morning. I lost about a half a pound a week, which was lower than I had by calorie counting in the past.

Quit the Wegovy and added a low dose of bupropion, and all of that reversed in a month.

I am overweight, not obese, have an A1C of 4.7, and run regularly. I've never had food noise. YMMV.

Mine were mainly around bloating and abdominal pain, but I solved it by spacing the doses out further to once every 10 days (I'm already about as low as you can get at 1mg without making it difficult to measure accurately in the normal insulin syringe). My working theory is some people don't clear the drug as fast as the modeled rate, so once every 7 days starts to slowly accumulate. I didn't have symptoms until after 12 weeks on a weekly dose.

Gastrointestinal - nausea, extreme fullness, paradoxically both rapid and slow transit (I recommend lots of fiber, but that will make you too full too), bloating, all kinds of negative stuff, and obviously if you're on a calorie deficit because you get full off a single bite of food you're going to have low energy and feel pretty garbage on that front (thus ramp slowly), but also some jitteryness, all manner of things. I would call the first week on a tiny dose something like a very mild GI bug or flu, in terms of everything I experienced.

That said, I'm extremely prone to side effects, most people I know who have tried them started at maybe half the standard dose and had zero side effects at all. I'm the best possible guinea pig for these things, because if I can tolerate it, almost anyone who isn't frankly allergic or something can.

The other downside, obviously, is injections - you will need to learn how to use sterile technique to inject yourself or pay the incredibly high costs for the pens. The pills are also an option but I have no personal experience and their bioavailability is so low I don't know that I fully trust them.

They will completely change your relationship with food and alcohol, too. Your tastes will probably shift, nearly everybody I know who is on them has essentially given up booze (maybe a couple drinks a year, more or less)

In my experience, basically all downsides can be solved by lowering the dose, and not escalating dosages as fast as the doctors tell you.