Clinical psychologist specializing in body identity transitions. What you're describing is a textbook presentation of what I call somatic imposter syndrome — the feeling that your physical body is inauthentic because the method of change doesn't align with cultural narratives of "earning" thinness through suffering.

Let's unpack the belief: "I didn't earn it."

Did you make the appointment? Did you research the medication? Did you inject yourself every week? Did you deal with nausea, fatigue, and GI side effects? Did you show up to your own life every single day in a society that shames both fat bodies AND the methods people use to change them? Did you navigate the emotional upheaval of losing your primary coping mechanism?

You earned it. You're earning it every day. The medication is a tool, not a cheat code. A surgeon uses a scalpel — we don't say they "didn't earn" the surgery because they used an instrument.

The imposter feeling will fade as your psychological identity catches up with your physical reality. But it takes time. Be patient with the lag.

God, this resonates. I've lost 90 lbs and I literally apologize when people compliment me. Like they'll say "you look amazing" and I'll say "oh, it's just a medication." JUST a medication. I minimize it every single time.

My buddy who's been going to the gym for 20 years gets compliments and says "thanks, I work hard." No qualifiers. No apology. No disclosure of his creatine or pre-workout or protein powder.

Why do I feel like I owe everyone a disclaimer? Why can't I just say thank you?

I want to address something that's underneath the imposter syndrome that nobody talks about: you feel guilty because society told you that being fat was a moral failing, and now you feel like you escaped punishment without doing penance.

Think about that. We've been so thoroughly conditioned to believe that weight loss must involve suffering — grueling workouts, starvation, deprivation — that when something works without torture, it feels like cheating. Like you skipped the line. Like you didn't pay the entry fee.

But the entry fee was never real. It was made up by a culture that profits from your shame. The diet industry, the fitness industry, the wellness industry — they all need you to believe that weight loss should be painful and expensive and take forever.

You don't owe anyone your suffering. You never did.

MikeNYC_runner, I just read your response three times. "You feel guilty because you escaped punishment without doing penance." That hit me like a freight train.

You're right. I literally feel like I'm getting away with something. Like the universe is going to correct this somehow — like the weight will come back as punishment for not suffering enough to lose it.

That's so messed up. And so deeply embedded. How do I even begin to unlearn that?