NeuroNate said:

Dr.NateNeph said: ...mental health should only be used alongside therapy...

This is where I part company with the consensus forming above. 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.

Dr.NateNeph 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…

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. ✨

DataDave said:

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

Before/after narrative for mental health — one year in:

Before (281 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.

After (181 lbs): Run 3 miles regularly, pain-free, A1C normal, down to 1 medication, bought a swimsuit for the first time in a decade, actually enjoy being photographed.

Total weight lost: 81 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.

One thing that is still open after mia_MS2’s answer:

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

Closing the loop on my own question.

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.