JessicaH_TX said:

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

Pushing back on JessicaH_TX here. 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.

tyler_CSCS said:

My mood has been flatter since about month four and I genuinely cannot work out whether that is the drug, the deficit, or the fact that I no longer…

When to call your doctor about mental health side effects — a reference I wish I'd had:

Call immediately:

• Severe abdominal pain (could be pancreatitis)
• Vision changes (thyroid concern)
• Lump in neck (thyroid nodule)
• Severe vomiting/can't keep fluids down for 24h+

Schedule an appointment:

• Persistent nausea beyond 4 weeks
• Significant hair loss
• Mood changes or depression
• Gallbladder symptoms (RUQ pain after eating)

Dr.ReproEndo said:

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

Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 3. Not depression exactly, but a weird flatness. Food was my main coping mechanism and without that, I had to develop new ones.

Therapy has been essential. I'd strongly recommend anyone starting GLP-1 therapy also invest in mental health support. The physical transformation is only half the journey.

One thing that is still open after kim_atl_prep’s answer:

Did your prescriber agree with that reading, and if not what was their objection?

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.