Dr.ObesityMed said:fiona_VT said: ...mental health should only be used alongside therapy...
This is where I part company with the consensus forming above. 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.
fiona_VT said:My mood has been flatter since about month four and I genuinely cannot work out whether that is the drug, the deficit, or the fact that I no longer…
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.SurgeonPGH said:I would be careful about how confidently the flatness reports get attributed.
Mood changes on mental health: I want to be transparent — I went through a rough patch emotionally around month 3. Not depression exactly, but a weird flatness. Food was my main coping mechanism and without that, I had to develop new ones.
Therapy has been essential. I'd strongly recommend anyone starting GLP-1 therapy also invest in mental health support. The physical transformation is only half the journey.
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View ResultsA narrower follow-up, since the general answer is now clear:
What would you measure differently if you were starting again?
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.