I do not recognize myself in photos and it is messing with my head

DanielChem_CHI said:

Body image adjustment with mental health: I've lost 78 lbs but when I look in the mirror, I still see my old self sometimes.

Pushing back on DanielChem_CHI here. 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.

JenMemphis 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…

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

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.

NeuroNate said:

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

Before/after narrative for mental health — one year in:

Before (262 lbs): Winded climbing stairs, chronic back pain, pre-diabetic, on 3 medications, dreaded mirrors, avoided photos, social anxiety about my weight.

After (197 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: 77 lbs. Total life gained: immeasurable. This isn't just about weight — it's about reclaiming your identity.

A narrower follow-up, since the general answer is now clear:

What did you change at the same time, and can you separate the two now?

OP back with an update, since a thread like this is useless without one.

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.