JennaRN said:

The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously.

When to call your doctor about mental health side effects — a reference I wish I'd had:

Call immediately:

• Severe abdominal pain (could be pancreatitis)
• Vision changes (thyroid concern)
• Lump in neck (thyroid nodule)
• Severe vomiting/can't keep fluids down for 24h+

Schedule an appointment:

• Persistent nausea beyond 4 weeks
• Significant hair loss
• Mood changes or depression
• Gallbladder symptoms (RUQ pain after eating)

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

Was that from a primary source or from a summary of one?

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…

Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 2. Not depression exactly, but a weird flatness. Food was my main coping mechanism and without that, I had to develop new ones.

Therapy has been essential. I'd strongly recommend anyone starting GLP-1 therapy also invest in mental health support. The physical transformation is only half the journey.

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.

Dr.LipidDallas said:

Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 2.

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.