NeuroNate said:

ricardo_MIA said: ...mental health should only be used alongside therapy...

I read this differently from NeuroNate, on substance rather than tone. 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.

ricardo_MIA said:

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

Body image adjustment with mental health: I've lost 69 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.

pete_manc_UK said:

I would be careful about how confidently the flatness reports get attributed.

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

Before (294 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.

After (189 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: 94 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.

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

What would you measure differently if you were starting again?

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.