ricardo_MIA said:

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

ricardo_MIA 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.

NeuroNate said:

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

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)

ricardo_MIA said:

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

Can confirm. Same sequence, different timescale.

Clinical perspective, offered as context rather than as advice.

Anxiety increase on mental health: counterintuitive, but losing weight rapidly triggered anxiety for me. Change — even positive change — is stressful. I was anxious about people treating me differently.

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.