DanielChem_CHI 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…

I read this differently from DanielChem_CHI, on substance rather than tone. 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.

HealthEcon_DC said:

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

Therapy insights from my mental health journey: my therapist introduced me to the concept of "identity updating" — the psychological work of becoming a new version of yourself.

Key realizations: I used food to manage emotions, I had internalized fatphobia that I'm still unpacking, my social identity was partly built around being "the big guy/girl," and learning to accept compliments is surprisingly hard when you've been invisible for years.

Physical transformation without emotional processing is unstable. Do both.

Dr.CardioMD said:

I would be careful about how confidently the flatness reports get attributed.

Body image adjustment with mental health: I've lost 74 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.

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

Did your prescriber agree with that reading, and if not what was their objection?

OP back with an update, since a thread like this is useless without one.

Follow-up — I put something in the gap where food used to be rather than waiting for the gap to close on its own. That was the part nobody told me.