My mood has been flatter since about month four and I genuinely cannot work out whether that is the drug, the deficit, or the fact that I no longer have my main coping mechanism.
What I actually want to know is how people separated a drug effect from the ordinary consequences of a large deficit and disrupted sleep, because I cannot.
I would rather have one careful answer than five confident ones.
PedsEndoPhilly said:My mood has been flatter since about month four and I genuinely cannot work out whether that is the drug, the deficit, or the fact that I no longer…
Body image adjustment with mental health: I've lost 91 lbs but when I look in the mirror, I still see my old self sometimes. "Phantom fat" is a real phenomenon.
My therapist specializes in body image issues with weight loss patients. She says it can take 12-18 months for your brain's body map to update. In the meantime: take progress photos (your eyes lie but cameras don't), try on old clothes, and be patient with yourself.
Dr.NateNeph said:Body image adjustment with mental health: I've lost 91 lbs but when I look in the mirror, I still see my old self sometimes.
Dr.NateNeph 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.
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Browse GL BiochemPedsEndoPhilly said:My mood has been flatter since about month four and I genuinely cannot work out whether that is the drug, the deficit, or the fact that I no longer…
Second this.
Clinical perspective, offered as context rather than as advice.
One year anniversary on mental health — reflections:
What I wish I'd known: the side effects are temporary, the benefits compound over time, protein is more important than I thought, and the mental health aspect needs as much attention as the physical.
What surprised me: how much my relationship with food changed, the cascade of health improvements beyond weight, and how supportive this community is.
What I'd do differently: start therapy earlier, prioritize resistance training from day 1, and stop comparing my progress to others. Everyone's journey is unique.