Therapy is just as important as the medication - my experience — November 2025

rick_sfbay said:

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

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

Before (282 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.

After (177 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: 82 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.

A narrower follow-up, since the general answer is now clear:

Did your prescriber agree with that reading, and if not what was their objection?

BethLabQueen said:

Before/after narrative for mental health — one year in: Before (282 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications,…

Body image adjustment with mental health: I've lost 94 lbs but when I look in the mirror, I still see my old self sometimes. "Phantom fat" is a real phenomenon.

My therapist specializes in body image issues with weight loss patients. She says it can take 12-18 months for your brain's body map to update. In the meantime: take progress photos (your eyes lie but cameras don't), try on old clothes, and be patient with yourself.

Closing the loop on my own question.

Update: I got the sleep and the intake sorted before deciding it was the drug, and most of the flatness went with them. Not all of it, and I am watching the rest.

hyun_seoul said:

Body image adjustment with mental health: I've lost 94 lbs but when I look in the mirror, I still see my old self sometimes.

One year anniversary on mental health — reflections:

What I wish I'd known: the side effects are temporary, the benefits compound over time, protein is more important than I thought, and the mental health aspect needs as much attention as the physical.

What surprised me: how much my relationship with food changed, the cascade of health improvements beyond weight, and how supportive this community is.

What I'd do differently: start therapy earlier, prioritize resistance training from day 1, and stop comparing my progress to others. Everyone's journey is unique.