Dr.AddMedPHL said:

When to call your doctor about mental health side effects — a reference I wish I'd had: Call immediately: Severe abdominal pain (could be…

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.

RunnerRach said:

Before/after narrative for mental health — one year in: Before (255 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications,…

This is exactly what I could not find anywhere else. Printing the relevant bit and taking it with me.

Dr.AddMedPHL said:

When to call your doctor about mental health side effects — a reference I wish I'd had: Call immediately: Severe abdominal pain (could be…

Dr.AddMedPHL 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.

denise_HTX said:

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

Recovering from an eating disorder and using mental health: this is a complex situation and I want to be transparent about it.

I have a history of binge eating disorder. My psychiatrist, therapist, and prescribing doctor all collaborate on my care. The GLP-1 agonist has actually been therapeutic — it removes the biological urgency of binge impulses without relying on restriction.

This is NOT appropriate for all ED patients. Anorexia, bulimia, and restrictive EDs require different approaches. But for BED specifically, the evidence and my personal experience are positive. Always involve your mental health team.

Moderator note: a couple of off-topic posts removed. Report rather than reply if it drifts again.