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. ✨

DanielChem_CHI said:

When to call your doctor about mental health side effects — a reference I wish I'd had: Call immediately: Severe abdominal pain (could be…

Body image adjustment with mental health: I've lost 67 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.

One thing that is still open after DanielChem_CHI’s answer:

What did you change at the same time, and can you separate the two now?

dave_SLC said:

Body image adjustment with mental health: I've lost 67 lbs but when I look in the mirror, I still see my old self sometimes.

I am going to disagree with the direction of travel here. The thread has converged on the tidiest answer rather than the best-supported one, and those are not the same thing.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Report rather than reply if it drifts again.