What I wish I knew before starting GLP-1 therapy — July 2024

Dr.PainCLE said:

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

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.PainCLE said:

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

I read this differently from Dr.PainCLE, on substance rather than tone. I would be careful about how confidently the flatness reports get attributed. Rapid weight loss, a large deficit and disrupted sleep produce low mood on their own, and separating that from a drug effect is genuinely hard.

pete_manc_UK said:

I would be careful about how confidently the flatness reports get attributed.

Anxiety increase on mental health: counterintuitive, but losing weight rapidly triggered anxiety for me. Change — even positive change — is stressful. I was anxious about loose skin.

This is more common than people admit. A therapist who specializes in weight management has been invaluable. Don't neglect the mental health side of this journey.

amsterdam_pete 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. I had assumed I was the exception until I read this.