Clinical perspective, offered as context rather than as advice.

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. ✨

labquiet_amy said:

Before/after narrative for mental health — one year in: Before (257 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications,…

Body image adjustment with mental health: I've lost 65 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.

A narrower follow-up, since the general answer is now clear:

How would you tell the difference between that and the alternative explanation?

NicoleRaleigh said:

Body image adjustment with mental health: I've lost 65 lbs but when I look in the mirror, I still see my old self sometimes.

I am going to disagree with the direction of travel here. The thread has converged on the tidiest answer rather than the best-supported one, and those are not the same thing.

Moderator note: a couple of off-topic posts removed.