NeuroNate said:

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

Body image adjustment with mental health: I've lost 56 lbs but when I look in the mirror, I still see my old self sometimes. "Phantom fat" is a real phenomenon.

My therapist specializes in body image issues with weight loss patients. She says it can take 12-18 months for your brain's body map to update. In the meantime: take progress photos (your eyes lie but cameras don't), try on old clothes, and be patient with yourself.

Following on from Dr.ObesityLA — and this may be the naive question:

How long did you give it before you decided it was working?

LabKate said:

Body image adjustment with mental health: I've lost 56 lbs but when I look in the mirror, I still see my old self sometimes.

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.

Reporting back.

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.PainCLE said:

Anxiety increase on mental health: counterintuitive, but losing weight rapidly triggered anxiety for me.

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.