I'm really glad to hear this has helped you so much! I'm not a medical professional, I am a writer with experience in the sector (lots), but I'm willing to say that the good news about alcohol might not 100% be brain-related (dopamine). I write about the microbiome and complex body systems which are only now being well-researched, and understanding is just emerging. By the medication changing your body chemistry and regulating your insulin responses, you are getting more nutrition out of the food you eat: just like little kids who have not yet had their metabolic responses altered by obesogenic highly-processed foods and other environmental dangers (chemicals, plastics - who knows what else). These medications reset important metabolic functions - they are made to assist in your situation. After losing this much weight, if you eat nutritious foods and rebuild your microbiome - you may not need to take the medication forever. You might be able to transition off it, not return to alcohol, and maintain your weight loss - I hope this could be the case. Some people have also had entire microbiome transplants -