Dr.MetabolicMD said:

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

Positive side effects of mental health that surprised me:

1. Clearer skin — inflammation reduction improved my rosacea
2. Better sleep — weight loss resolved mild sleep apnea
3. Improved libido — better body image + improved cardiovascular health
4. Less joint pain — obvious mechanical benefit
5. More energy — metabolic improvements across the board

Not everything about GLP-1 therapy is a struggle. There are genuinely wonderful changes too. ✨

One thing that is still open after roxy_nash’s answer:

How long did you give it before you decided it was working?

Dr.NateNeph said:

Positive side effects of mental health that surprised me: Clearer skin — inflammation reduction improved my rosacea Better sleep — weight loss…

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

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.

OP back with an update, since a thread like this is useless without one.

Follow-up — I put something in the gap where food used to be rather than waiting for the gap to close on its own. That was the part nobody told me.

Dr.EndoEP said:

Anxiety increase on mental health: counterintuitive, but losing weight rapidly triggered anxiety for me.

Before/after narrative for mental health — one year in:

Before (270 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.

After (190 lbs): Run 3 miles regularly, pain-free, A1C normal, down to 1 medication, bought a swimsuit for the first time in a decade, actually enjoy being photographed.

Total weight lost: 85 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.