Dr.AddMedPHL said:

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

Dr.AddMedPHL 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.

Dr.AddMedPHL said:

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

Pushing back on Dr.AddMedPHL here. I would be careful about how confidently the flatness reports get attributed. Rapid weight loss, a large deficit and disrupted sleep produce low mood on their own, and separating that from a drug effect is genuinely hard.

sarah.morrison said:

I would be careful about how confidently the flatness reports get attributed.

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

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.

JessicaH_TX said:

Dr.AddMedPHL said: ...mental health should only be used alongside therapy...

This is my experience too, for whatever a second data point is worth. I had assumed I was the exception until I read this.