Dr.KarenChen said:Training does two things here and only one of them is on the scale.
Thank you for spelling out the reasoning rather than just the conclusion. Sending this to two other people who asked me the same thing last week.
Clinical perspective, offered as context rather than as advice.
andrew_nyc said:...mental health should only be used alongside therapy...
I'd say therapy should be AVAILABLE to all GLP-1 patients, but requiring it as a precondition for treatment would create an access barrier.
Not everyone can afford therapy. Not everyone needs it. Some people do just fine with medication + lifestyle changes. But for those with emotional eating, body image issues, or disordered eating history, therapy is extremely valuable.
My recommendation: make mental health screening part of the initial assessment, offer therapy as a recommended adjunct, but don't gatekeep medication access behind it.
sean_dublin said:Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 3.
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.
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Browse GL Biochemandrew_nyc said:The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously.
Anxiety increase on mental health: counterintuitive, but losing weight rapidly triggered anxiety for me. Change — even positive change — is stressful. I was anxious about whether I deserved to feel good.
This is more common than people admit. A therapist who specializes in weight management has been invaluable. Don't neglect the mental health side of this journey.
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