james_edin said:

Body image adjustment with mental health: I've lost 68 lbs but when I look in the mirror, I still see my old self sometimes.

Thank you for spelling out the reasoning rather than just the conclusion. Adding it to my notes with a link back to this thread.

From the other side of the consultation, briefly.

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

Before (270 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.

After (180 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: 85 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.

julia.endo said:

labquiet_amy said: ...mental health should only be used alongside therapy...

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.

Dr.AddMedPHL said:

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

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)

Moderator note: a post naming a supplier has been edited. Discuss suppliers in the review sections, not here.