The psychological adjustment to rapid weight loss — need advice

Dr.KarenChen said:

When to call your doctor about mental health side effects — a reference I wish I'd had: Call immediately: Severe abdominal pain (could be…

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.

FitDadDave said:

Body image adjustment with mental health: I've lost 82 lbs but when I look in the mirror, I still see my old self sometimes.

This answered a question I did not know how to ask.

Dr.KarenChen said:

When to call your doctor about mental health side effects — a reference I wish I'd had: Call immediately: Severe abdominal pain (could be…

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.

denise_HTX said:

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

denise_HTX 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.

Moderator note: a post naming a supplier has been edited. Discuss suppliers in the review sections, not here. Report rather than reply if it drifts again.