Imposter syndrome after weight loss — need advice

CryptoCarl said:

The weight came off and the harder part started, which is not what any of the material I read had prepared me for.

Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 4. 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.

Dr.NutriCornell said:

Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 4.

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.

CryptoCarl said:

The weight came off and the harder part started, which is not what any of the material I read had prepared me for.

Same experience, arrived at from the opposite direction.

From the other side of the consultation, briefly.

CryptoCarl 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.