KarenAZ_mom said:

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

Therapy insights from my mental health journey: my therapist introduced me to the concept of "identity updating" — the psychological work of becoming a new version of yourself.

Key realizations: I used food to manage emotions, I had internalized fatphobia that I'm still unpacking, my social identity was partly built around being "the big guy/girl," and learning to accept compliments is surprisingly hard when you've been invisible for years.

Physical transformation without emotional processing is unstable. Do both.

One thing that is still open after anna.melb_AU’s answer:

What did you change at the same time, and can you separate the two now?

kate.chem said:

Therapy insights from my mental health journey: my therapist introduced me to the concept of "identity updating" — the psychological work of becoming…

Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 4. 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.

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.PulmRoch said:

Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 4.

Before/after narrative for mental health — one year in:

Before (262 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.

After (192 lbs): Run 3 miles regularly, pain-free, A1C normal, down to 1 medication, bought a swimsuit for the first time in a decade, actually enjoy being photographed.

Total weight lost: 92 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.