Dr.GastroMayo 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…

Dr.GastroMayo 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.

traveltech_sara said:

Body image adjustment with mental health: I've lost 93 lbs but when I look in the mirror, I still see my old self sometimes.

Bookmarking. The distinction being drawn above is the one nobody else makes.

Dr.GastroMayo 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…

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. ✨

emma_london 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…

Recovering from an eating disorder and using mental health: this is a complex situation and I want to be transparent about it.

I have a history of binge eating disorder. My psychiatrist, therapist, and prescribing doctor all collaborate on my care. The GLP-1 agonist has actually been therapeutic — it removes the biological urgency of binge impulses without relying on restriction.

This is NOT appropriate for all ED patients. Anorexia, bulimia, and restrictive EDs require different approaches. But for BED specifically, the evidence and my personal experience are positive. Always involve your mental health team.

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