LarryQC_SD said:

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

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.

LarryQC_SD 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.

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 (275 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: 90 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.

Dr.MetabolicMD said:

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

Can confirm. Same sequence, different timescale. Nothing to add that would improve it.