LabKate 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.

LabKate said:

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

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. 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.

Dr.CardioMD said:

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

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.

Dr.SurgeonPGH said:

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

Adding a me-too, because a thread of one person's experience is not much use. I had assumed I was the exception until I read this.