NeuroNate said:

Before/after narrative for mental health — one year in: Before (271 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications,…

This is where I part company with the consensus forming above. 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.

Ask again with the specifics and you will get a better answer than this one.

JenMemphis 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…

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.

Dr.PeteFamMed 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 people treating me differently.

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.

Following on from anders_CPH — and this may be the naive question:

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

OP back with an update, since a thread like this is useless without one.

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.