sophie_paris said:

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

sophie_paris said:

...mental health should only be used alongside therapy...

I'd say therapy should be AVAILABLE to all GLP-1 patients, but requiring it as a precondition for treatment would create an access barrier.

Not everyone can afford therapy. Not everyone needs it. Some people do just fine with medication + lifestyle changes. But for those with emotional eating, body image issues, or disordered eating history, therapy is extremely valuable.

My recommendation: make mental health screening part of the initial assessment, offer therapy as a recommended adjunct, but don't gatekeep medication access behind it.

sophie_paris said:

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

I read this differently from sophie_paris, 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.

That is the short version; the long version is somebody else's post.

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 whether I deserved to feel good.

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.

BariatricNurseD said:

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

This matches mine closely enough to be worth saying so out loud. Posting only so the count is not one.