RetaRick_CA said:

DebRD_ATL said: ...mental health should only be used alongside therapy...

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. I would be careful about how confidently the flatness reports get attributed. Rapid weight loss, a large deficit and disrupted sleep produce low mood on their own, and separating that from a drug effect is genuinely hard.

DebRD_ATL 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…

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.

julia.endo said:

I would be careful about how confidently the flatness reports get attributed.

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

Before (297 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.

After (197 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: 97 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.

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

What did you change at the same time, and can you separate the two now?

Reporting back.

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.