MikeFit_NJ said:

When to call your doctor about mental health side effects — a reference I wish I'd had: Call immediately: Severe abdominal pain (could be…

This is where I part company with the consensus forming above. 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.

SaraMom3 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 2. 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.

amsterdam_pete said:

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

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.

Following on from steph_laguna — and this may be the naive question:

What would you measure differently if you were starting again?

Reporting back.

Update: I got the sleep and the intake sorted before deciding it was the drug, and most of the flatness went with them. Not all of it, and I am watching the rest.