DanielChem_CHI said:Recovering from an eating disorder and using mental health: this is a complex situation and I want to be transparent about it.
Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. 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.
That is the short version; the long version is somebody else's post.
Dr.RaviCardio said:The weight came off and the harder part started, which is not what any of the material I read had prepared me for.
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.
Dr.NateNeph said:I would be careful about how confidently the flatness reports get attributed.
Dr.NateNeph 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.
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View ResultsFollowing on from gary_naperville — and this may be the naive question:
What would you measure differently if you were starting again?
OP back with an update, since a thread like this is useless without one.
Follow-up — I put something in the gap where food used to be rather than waiting for the gap to close on its own. That was the part nobody told me.