How did you get from reduced appetite to starvation state? I'm not on one of these drugs myself, but from friends I've been talking to, it seems like (after a bit of dosage tuning) it's reducing their appetite to what would be expected from a person who never was obese. So they do lose weight relatively rapidly, especially at the start, but I don't see why we should equate weight loss with starvation.

As for "how it's better", - the answer is clearly that unlike "exercise and eating right", these drugs are leading to positive behavioral change at scale. I'm perhaps slightly exaggerating, but to the best of my knowledge, no other substance over the last several thousand years has had such a clear positive effect on humanity as a whole.