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ForumsPsychological & BehavioralGLP-1 and gambling reduction — 6 month update

GLP-1 and gambling reduction — 6 month update

JakeSmashed95 Thu, Jul 3, 2025 at 4:20 AM 29 replies 1,842 viewsPage 1 of 6
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JakeSmashed95
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Jul 3, 2025 at 4:20 AM#1

Read the primary source rather than the write-up and the two do not agree, so here is what is actually in it.

The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously. On the positive side: reduced anxiety around food, better self-image, more confidence. On the difficult side: grief for the years lost, identity disruption, relationships built around eating, and the loss of food as a coping mechanism with nothing put in its place. Rarer but real: anhedonia and emotional flatness. Regulators have started asking for validated patient-reported outcomes in this class; the existing data gap is not evidence of absence.

Where I think it is weakest: the completion rate deserves as much attention as the headline, because a large effect among those who finished is a different claim from a large effect among those enrolled.

What I actually want to know is how people separated a drug effect from the ordinary consequences of a large deficit and disrupted sleep, because I cannot. I would rather have one careful answer than five confident ones.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
48 18Dr.PainCLE, mike_mealprep, NicoleRaleigh and 45 others
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Dr.KarenChen
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Jul 3, 2025 at 4:37 AM#2
JakeSmashed95 said:
The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously.

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.

Last edited: Jul 3, 2025 at 10:37 AM
47 17JessicaM_2024, TomFromTexas, mike.trainer_LA and 44 others
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LabKate
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Jul 3, 2025 at 4:54 AM#3
JakeSmashed95 said:
The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. 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.

46 16Dr.SleepRoch, laura_annarbor, JenMemphis and 43 others
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Dr.CardioMD
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Jul 3, 2025 at 5:11 AM#4
LabKate said:
I would be careful about how confidently the flatness reports get attributed.
LabKate 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.

45 15roxy_nash, tony_orlando, Dr.NephBHM_UK and 42 others
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quinn_sf
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Jul 3, 2025 at 6:42 AM#5
Dr.KarenChen said:
One year anniversary on mental health — reflections: What I wish I'd known: the side effects are temporary, the benefits compound over time, protein…

Adding a me-too, because a thread of one person's experience is not much use. Nothing to add that would improve it.

Last edited: Jul 3, 2025 at 12:42 PM
44 14Dr.EndoEP, GraceAZ_72, carl_compliance and 41 others
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