The weight came off and the harder part started, which is not what any of the material I read had prepared me for.
The narrow version of the question is how people separated a drug effect from the ordinary consequences of a large deficit and disrupted sleep, because I cannot.
If the honest answer is that nobody knows, that is a useful answer and I would rather have it.
CryptoCarl said:The weight came off and the harder part started, which is not what any of the material I read had prepared me for.
Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 4. Not depression exactly, but a weird flatness. Food was my main coping mechanism and without that, I had to develop new ones.
Therapy has been essential. I'd strongly recommend anyone starting GLP-1 therapy also invest in mental health support. The physical transformation is only half the journey.
Dr.NutriCornell said:Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 4.
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 BiochemCryptoCarl 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 experience, arrived at from the opposite direction.
From the other side of the consultation, briefly.
CryptoCarl 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.