Dr.PeteFamMed said:

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

Pushing back on Dr.PeteFamMed here. 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.

DadBodDave said:

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

When to call your doctor about mental health side effects — a reference I wish I'd had:

Call immediately:

• Severe abdominal pain (could be pancreatitis)
• Vision changes (thyroid concern)
• Lump in neck (thyroid nodule)
• Severe vomiting/can't keep fluids down for 24h+

Schedule an appointment:

• Persistent nausea beyond 4 weeks
• Significant hair loss
• Mood changes or depression
• Gallbladder symptoms (RUQ pain after eating)

RetaRick_CA said:

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

Body image adjustment with mental health: I've lost 84 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.

A narrower follow-up, since the general answer is now clear:

What would you measure differently if you were starting again?

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

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.