sarah_nash92 said:

My mood has been flatter since about month four and I genuinely cannot work out whether that is the drug, the deficit, or the fact that I no longer…

Body image adjustment with mental health: I've lost 83 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.

labquiet_amy said:

Body image adjustment with mental health: I've lost 83 lbs but when I look in the mirror, I still see my old self sometimes.

labquiet_amy 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.

sarah_nash92 said:

My mood has been flatter since about month four and I genuinely cannot work out whether that is the drug, the deficit, or the fact that I no longer…

Second this.

Clinical perspective, offered as context rather than as advice.

Positive side effects of mental health that surprised me:

1. Clearer skin — inflammation reduction improved my rosacea
2. Better sleep — weight loss resolved mild sleep apnea
3. Improved libido — better body image + improved cardiovascular health
4. Less joint pain — obvious mechanical benefit
5. More energy — metabolic improvements across the board

Not everything about GLP-1 therapy is a struggle. There are genuinely wonderful changes too. ✨