Dr.EndoEP said:

Body image adjustment with mental health: I've lost 84 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.

tammy_FL said:

Before/after narrative for mental health — one year in: Before (276 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications,…

That reframing is the part I needed.

Dr.EndoEP said:

Body image adjustment with mental health: I've lost 84 lbs but when I look in the mirror, I still see my old self sometimes.

One year anniversary on mental health — reflections:

What I wish I'd known: the side effects are temporary, the benefits compound over time, protein is more important than I thought, and the mental health aspect needs as much attention as the physical.

What surprised me: how much my relationship with food changed, the cascade of health improvements beyond weight, and how supportive this community is.

What I'd do differently: start therapy earlier, prioritize resistance training from day 1, and stop comparing my progress to others. Everyone's journey is unique.

DadBodDave said:

The weight came off and the harder part started, which is not what any of the material I read had prepared me for.

DadBodDave 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.

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Carry on.