Clinical perspective, offered as context rather than as advice.

One year anniversary on mental health — reflections:

What I wish I'd known: the side effects are temporary, the benefits compound over time, protein is more important than I thought, and the mental health aspect needs as much attention as the physical.

What surprised me: how much my relationship with food changed, the cascade of health improvements beyond weight, and how supportive this community is.

What I'd do differently: start therapy earlier, prioritize resistance training from day 1, and stop comparing my progress to others. Everyone's journey is unique.

lisa_labSD said:

Body image adjustment with mental health: I've lost 91 lbs but when I look in the mirror, I still see my old self sometimes.

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.

The figures, for anyone assembling their own picture. If you are going to change something, change one thing and give it long enough to express itself. Four weeks is the usual minimum for anything pharmacological on this board, and two weeks of data has told you almost nothing.

Ask again with the specifics and you will get a better answer than this one.

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

What would you measure differently if you were starting again?

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