GLP-1 and self-image — 6 month update

Dr.LeslieOBGYN said:

Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 2.

Mine went the same way, slower.

dan_philly said:

Anxiety increase on mental health: counterintuitive, but losing weight rapidly triggered anxiety for me.

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.

dan_philly said:

Anxiety increase on mental health: counterintuitive, but losing weight rapidly triggered anxiety for me.

dan_philly 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.

Following on from dan_philly — and this may be the naive question:

What would you measure differently if you were starting again?

Moderator note: a couple of off-topic posts removed.