Dr.ObesityMed said:

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

I read this differently from Dr.ObesityMed, 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.

JessicaM_2024 said:

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

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

Before (293 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.

After (198 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: 93 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.

FDA_TrackerJim said:

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

Body image adjustment with mental health: I've lost 80 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.

One thing that is still open after Dr.PathRoch’s answer:

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

Reporting back.

Update: I got the sleep and the intake sorted before deciding it was the drug, and most of the flatness went with them. Not all of it, and I am watching the rest.