Cognitive effects of GLP-1 agonists — need advice

Clinical perspective, offered as context rather than as advice.

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.

Adding the clinical framing, because it changes how the question reads.

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.

Dr.PeteFamMed said:

Recovering from an eating disorder and using mental health: this is a complex situation and I want to be transparent about it.

Same pattern here, and in the same order. Posting only so the count is not one.

Dr.PeteFamMed said:

Recovering from an eating disorder and using mental health: this is a complex situation and I want to be transparent about it.

Coming at Dr.PeteFamMed’s question from a different direction. The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either. Those three things can all be true at once, and most arguments here are two people holding different parts of that.

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