labquiet_amy said:

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

I read this differently from labquiet_amy, on substance rather than tone. 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.

roxy_nash said:

The weight came off and the harder part started, which is not what any of the material I read had prepared me for.

Body image adjustment with mental health: I've lost 62 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.

BethLabQueen said:

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

Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 3. 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.

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

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

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.