SkepticalSean said:

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

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

Before (261 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.

After (176 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: 91 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.

MikeFit_NJ said:

Before/after narrative for mental health — one year in: Before (261 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications,…

MikeFit_NJ 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.

SkepticalSean said:

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

Adding a me-too, because a thread of one person's experience is not much use. Posting only so the count is not one.

From the other side of the consultation, briefly.

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

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.