From the other side of the consultation, briefly.

kate.chem 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.

A narrower follow-up, since the general answer is now clear:

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

Dr.EM_Chicago said:

kate.chem said: ...mental health should only be used alongside therapy...

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

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.

Dr.EM_Chicago said:

kate.chem said: ...mental health should only be used alongside therapy...

Agreed, and the size of the effect matters as much as its existence. Something real and small gets treated here as though it were real and decisive.

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful.