GLP-1 and self-image — rebuilding identity after transformation

SaraMom3 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…

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.MetabolicMD said:

Therapy insights from my mental health journey: my therapist introduced me to the concept of "identity updating" — the psychological work of becoming…

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.

SaraMom3 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…

Same pattern here, and in the same order. I had assumed I was the exception until I read this.

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

Body image adjustment with mental health: I've lost 64 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.