I do not recognize myself in photos and it is messing with my head — July 2024

LarryQC_SD said:

The mental-health dimension is under-measured in the trial literature and the reports here are consistent enough to take seriously.

Body image adjustment with mental health: I've lost 58 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.

One thing that is still open after james_edin’s answer:

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

TrialTracker_MD said:

Body image adjustment with mental health: I've lost 58 lbs but when I look in the mirror, I still see my old self sometimes.

TrialTracker_MD 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.

Closing the loop on my own question.

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.RenalNash said:

TrialTracker_MD said: ...mental health should only be used alongside therapy...

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

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.