andrew_nyc 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.

Following on from Dr.KarenChen — and this may be the naive question:

What training is actually for during a large deficit, because framing it as calorie burn sets people up to quit when the arithmetic disappoints them?

VendorMark said:

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

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.

Closing the loop on my own question.

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.

sean_dublin said:

Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 3.

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)