"Best" depends on what we are looking for, right?

There is a reason that the new GLP-1 RA medications have made such a splash -- they reliably work for most (although not all) people, and do so pretty rapidly. Most other weight loss drugs either work poorly (if at all) or are actively dangerous. If you want to go with other drugs (especially over-the-counter, including herbals and supplements), check out the clinical trials first, and look at any FDA evidence of problems.

I started taking tirzepatide (zepbound) at age 72, and have posted about it before on these blogs. I knew from a lifetime's worth of experience that I would regain the weight I lost plus more doing anything resembling a combination of diet and exercise. Only two solutions have genuinely worked for me in the past, and even they eventually failed: (1) a medically-supervised fast (which really meant living off an extremely low calorie prescription beverage regime), which demonstrated that if I could entirely give up food, I had no difficulties, and (2) bariatric surgery, after which the weight came back very, very slowly.

If I were you, I would do none of those things if this is your first experience with weight loss -- learning new eating habits makes more sense than drugs as a first solution. Plus, learning to eat more healthily and mindfully will stand you in good stead if you do try any of the more serious options. If this is not your first rodeo...

From what I can tell, medically-supervised fasts are no longer available.

Bariatric surgery is a great alternative at pretty much any age, if you qualify and are ready for it. It was coupled with the best behavioral re-training experience I've ever had, which has helped me greatly in my latest use of the GLP-1 RAs. Some people do experience side effects, as I did, but any solution that reliably works risks those. The big advantage of surgery over the GLP-1s (or any drug) is that it's one-and-done. You really, really want to take the prep and follow-up seriously -- I've got a friend who essentially lied her way through the process, and it didn't end well.

Most recently, I lost all the weight I had regained since the surgery, using first tirzepatide (zepbound) and now semaglutide (ozempic). I've had a variety of side effects (as with the surgery, most people do not experience side effects, but some, like me, definitely do), and that was the primary reason that led me to switch drugs within the GLP-1 RA family. The big advantage of these drugs is that in most cases, the side effects go away if and when you stop the drugs -- you can't stop surgery (although the surgeries can be reversed if necessary). The big disadvantage is that no one has figured out a great way to get off of them -- usually, if you don't stick with the drugs, the weight comes right back. (And unlike the surgery, there's no systematic prep and follow-up, which means they just give you the drug with no wrap-around services to address our underlying issues.) Therefore, you may be on the drugs for life.

But age is not a problem with any of these.