Gym anxiety after major weight loss — looking for input

Dr.EndoEP 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.

Positive side effects of mental health that surprised me:

1. Clearer skin — inflammation reduction improved my rosacea
2. Better sleep — weight loss resolved mild sleep apnea
3. Improved libido — better body image + improved cardiovascular health
4. Less joint pain — obvious mechanical benefit
5. More energy — metabolic improvements across the board

Not everything about GLP-1 therapy is a struggle. There are genuinely wonderful changes too. ✨

pete_manc_UK said:

Agreed, with the caveat that "exercise" for someone with mobility limitations is a different set of options, and the standard advice is written as…

Saving this. It is the first explanation that did not require me to already understand it. Sending this to two other people who asked me the same thing last week.

Dr.EndoEP 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.

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.

raj_cambridge said:

The weight came off and the harder part started, which is not what any of the material I read had prepared me for.

When to call your doctor about mental health side effects — a reference I wish I'd had:

Call immediately:

• Severe abdominal pain (could be pancreatitis)
• Vision changes (thyroid concern)
• Lump in neck (thyroid nodule)
• Severe vomiting/can't keep fluids down for 24h+

Schedule an appointment:

• Persistent nausea beyond 4 weeks
• Significant hair loss
• Mood changes or depression
• Gallbladder symptoms (RUQ pain after eating)

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Carry on.