Dr.DermMIA said:

Before/after narrative for mental health — one year in: Before (262 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications,…

Bookmarking. The distinction being drawn above is the one nobody else makes. Taking it to my next appointment.

Adding the clinical framing, because it changes how the question reads.

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.GutHealth said:

Recovering from an eating disorder and using mental health: this is a complex situation and I want to be transparent about it.

Anxiety increase on mental health: counterintuitive, but losing weight rapidly triggered anxiety for me. Change — even positive change — is stressful. I was anxious about people treating me differently.

This is more common than people admit. A therapist who specializes in weight management has been invaluable. Don't neglect the mental health side of this journey.

DataDave said:

The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously.

Body image adjustment with mental health: I've lost 82 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.

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Report rather than reply if it drifts again.