The weight came off and the harder part started, which is not what any of the material I read had prepared me for.
What I am after is how people separated a drug effect from the ordinary consequences of a large deficit and disrupted sleep, because I cannot.
I have searched first, so if this is covered somewhere point me at it and I will read it.
roxy_nash said:The weight came off and the harder part started, which is not what any of the material I read had prepared me for.
roxy_nash said:...mental health should only be used alongside therapy...
I'd say therapy should be AVAILABLE to all GLP-1 patients, but requiring it as a precondition for treatment would create an access barrier.
Not everyone can afford therapy. Not everyone needs it. Some people do just fine with medication + lifestyle changes. But for those with emotional eating, body image issues, or disordered eating history, therapy is extremely valuable.
My recommendation: make mental health screening part of the initial assessment, offer therapy as a recommended adjunct, but don't gatekeep medication access behind it.
DebRD_ATL said:roxy_nash said: ...mental health should only be used alongside therapy...
Therapy insights from my mental health journey: my therapist introduced me to the concept of "identity updating" — the psychological work of becoming a new version of yourself.
Key realizations: I used food to manage emotions, I had internalized fatphobia that I'm still unpacking, my social identity was partly built around being "the big guy/girl," and learning to accept compliments is surprisingly hard when you've been invisible for years.
Physical transformation without emotional processing is unstable. Do both.
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Browse GL Biochemroxy_nash said:The weight came off and the harder part started, which is not what any of the material I read had prepared me for.
Same pattern here, and in the same order. I had assumed I was the exception until I read this.
Clinical perspective, offered as context rather than as advice.
Recovering from an eating disorder and using mental health: this is a complex situation and I want to be transparent about it.
I have a history of binge eating disorder. My psychiatrist, therapist, and prescribing doctor all collaborate on my care. The GLP-1 agonist has actually been therapeutic — it removes the biological urgency of binge impulses without relying on restriction.
This is NOT appropriate for all ED patients. Anorexia, bulimia, and restrictive EDs require different approaches. But for BED specifically, the evidence and my personal experience are positive. Always involve your mental health team.