I have a 44mm Watch 5 Cellular, got it brand new in Sept 2019. In the last few months I've really noticed a decline in battery life, so almost 4 years before it was noticeably bad. My next step is to fully turn off Cellular (I know it's supposed to be off if it's not in use, but that is an annoyance in itself because of the handoff time). I can get through a work day, but don't expect much else.
I use the 5w for both the watch and my iPhone 13 Pro Max. I use optimization for the phone but I turned that off for the watch because it wasn't aligning with my use, may be better now but it's been a couple years.