maria_elpaso said:

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

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

Before (265 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.

After (185 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: 95 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.

maria_elpaso said:

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

This is where I part company with the consensus forming above. 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.

TrialTracker_MD said:

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

Body image adjustment with mental health: I've lost 79 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.

Dr.PeteFamMed said:

Before/after narrative for mental health — one year in: Before (265 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications,…

Same experience, arrived at from the opposite direction. I had assumed I was the exception until I read this.