LabKate said:The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously.
LabKate 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 sophie_paris — and this may be the naive question:
How long did you give it before you decided it was working?
Dr.AddMedPHL said:LabKate said: ...mental health should only be used alongside therapy...
Before/after narrative for mental health — one year in:
Before (286 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.
After (191 lbs): Run 3 miles regularly, pain-free, A1C normal, down to 1 medication, bought a swimsuit for the first time in a decade, actually enjoy being photographed.
Total weight lost: 71 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.
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Shop Reference StandardsOP 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.
Dr.GastroMayo said:Before/after narrative for mental health — one year in: Before (286 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications,…
Body image adjustment with mental health: I've lost 92 lbs but when I look in the mirror, I still see my old self sometimes. "Phantom fat" is a real phenomenon.
My therapist specializes in body image issues with weight loss patients. She says it can take 12-18 months for your brain's body map to update. In the meantime: take progress photos (your eyes lie but cameras don't), try on old clothes, and be patient with yourself.