Posts in category: Dating Tips, Guide and Advice

Losing weight feels empowering and often boosts self-esteem. However, losing weight doesn’t equate to feeling better mentally. Some people who lose weight successfully might not feel entirely like themselves after the weight comes off.

“Well, you do have a heavy sweater and jeans on,” the nurse reassured me while I audibly gasped as soon as I stepped on the scale. It was a chilly November morning when I visited my local urgent care center for debilitating back pain thanks to a raging, unrelenting case of sciatica.

I could barely focus on what the doctor had to say when she entered the examination room. All I could think about was my weight – a frightening number I hadn’t seen before. How did I get here? What had I done over the last few years to pack the pounds on so quickly? The only thing I knew at that moment was that I had to do something.

GLP-1 Medication to the Rescue

It took a few months after this harrowing revelation before I started using GLP-1 (Glucagon-like peptide-1) medication, namely, Mounjaro (tirzepatide). I found a telehealth provider who gave me a prescription after submitting my height, weight, age, and a blood test. I’ll admit, I was a bit hesitant and scared of the potential side effects, mostly nausea (something that I find intolerable).

Once I started taking Mounjaro, the side effects were minimal and the weight slipped off me at breakneck speed. Even when I ate “whatever I wanted to,” I wouldn’t gain – I’d even lose a bit after the evenings my husband and I would go out to a nice restaurant and indulge in rich, heavy meals and a decadent dessert.

Initially, it was my goal to get back to my wedding weight. I had gained a significant amount since our wedding and told myself I’d be happy to just get back to that point. Before I knew it, I was 12 pounds below my wedding weight. After a year of using Mounjaro, I’m now down 45 pounds, which might not be as much weight loss compared to other users, but it’s an incredible victory for me. 

A respectable percentage of people taking Mounjaro lost approximately 15% of their starting body weight after using the medication as prescribed for 72 weeks. After 52 weeks (one full year), I was down by approximately 18% of my original body weight before starting the medication. Although losing weight was a personal success for me, my mind still doesn’t feel quite “right” and to put it bluntly, I don’t feel like myself anymore.

Mounjaro: What’s Changed for Me?

I’m physically smaller now, and my body fits into smaller clothing sizes. This still shocks me every time I get dressed and look in the mirror. Yet somehow, my brain still has a tough time connecting the joy of my weight loss to how I feel in other ways. 

Here are some things that have changed for me since embarking on my GLP-1 weight loss journey.

My Anxiety Is Off the Charts

I never dealt with anxiety before, but I do have attention-deficit/hyperactivity disorder (ADHD). This makes things a bit more challenging in my professional life as a writer. However, when I took ADHD medication before taking it in conjunction with Mounjaro, I never felt antsy or anxious, just focused and calm. 

Since I started Mounjaro, I get intense bouts of anxiety that occasionally make it difficult for me to focus and to feel at ease in general. I spend most of my day writing with deadlines dangling above my head, and piling on the anxiety makes my otherwise typical daily tasks difficult to manage. I feel burnt out and overwhelmed at the end of the day, and it sticks with me until I finally fall asleep.

Ironically, one study found that patients with diabetes who took GLP-1 medications had a lower likelihood of being diagnosed with depression and anxiety.

Insomnia Upends My Days

I’ve suffered from insomnia since I was a child. Sure, I have decent stretches when I sleep just fine, but when I don’t, the following day is hell. When I entered perimenopause, the insomnia started coming back in intense and brutal waves.

Once I started taking Mounjaro, I noticed that I tend to have sleepless nights on the evening of my weekly dose. Now I have to diligently plan when I take the medication, or else I’ll suffer the next day. Whenever I pair a night of little to no sleep with anxiety, it’s disastrous and can derail my day entirely.

The Anhedonia Is Real

It’s not set in stone, but some healthcare professionals theorize that GLP-1 drugs may directly interact with dopamine in the brain. Those dopamine receptors are what give you a feeling of satisfaction or reward. Although this may show that GLP-1 drugs have the potential to help people dealing with addiction, it might not work for people like me.

You see, since I’ve started taking Mounjaro, I don’t feel the same feelings of joy or elation that I once did. Things I used to get excited about barely make a blip on my radar. I wouldn’t say I’m depressed, but I would say it feels similar to anhedonia, an inability to experience joy or pleasure that makes me feel numb. You’d think it would be the opposite since losing the weight, but I constantly feel like I’m in a heavy mental fog that blocks sheer delight from my view.

Before taking this medication, I’d get giddy about the little things in life. Whether it was a friend coming to town to visit me or exciting dinner plans with my husband, those small yet personally significant things have sadly lost their shine. Of all the changes I’ve felt, this one has impacted me the most profoundly.

How I’m Coping

I still take Mounjaro once a week and don’t plan to stop until my doctor advises me to do so. However, I am doing a few things to try and mitigate these new changes in my mental health:

• I’m going to bed earlier to give myself more time to unwind and fall asleep.
• I’ve started practicing mindfulness like walking outside in the sunshine with my dog more often to help me feel calmer and more grounded.
• I make notes (mental and written) about what I’m grateful for, which helps me overcome the nagging feelings of numbness due to anhedonia.
• I take Mounjaro at night rather than in the morning since it takes a few hours to “kick in” for me.

While the maker of Mounjaro lists its side effects as only physical, I can say with confidence that this medication has had a profound impact on the way I feel mentally, too. 

Losing weight can bolster confidence, but it can also impact how others treat you. Knowing how to manage relationships and social changes after weight loss is vital to protect your mental health as you navigate the maze of feelings associated with having a “new body.”

Taking a GLP-1 (Glucagon-like peptide-1) medication has the potential to impact your weight in profound and sometimes unexpected ways. These revolutionary drugs often provide rapid results that can make you slimmer within mere months. While having a smaller body can certainly help you feel more confident, there are also some downsides, namely, the way other people start to treat you in your everyday life.

A poll conducted by KFF Health found that approximately 4 in 10 adults who said they took GLP-1 medication did so primarily to lose weight. Although significant weight loss has plenty of positive benefits for your mental and physical health, there’s also a darker side to living in a smaller body.

Facing Fatphobia

If you’re overweight, there’s a high likelihood that you’ve been forced to deal with a social stigma called fatphobia at some point in your lifetime. This inherent bias from others has the potential to affect people throughout their entire lives. Sadly, fatphobia often starts in childhood and continues well into adulthood.

The “symptoms” of fatphobia vary depending on the person experiencing it, but it might include things like:

• being intentionally left out of social circles
• feeling ignored and unseen
• or even being mocked or made fun of privately and in public.

This awful, and quite frankly, immature behavior toward those who are overweight can have significant consequences on your mental health, and could even negatively affect your experiences when dealing with healthcare professionals.

Dr. Robert F Kushner, MD, a doctor and professor of medicine (endocrinology) at Northwestern Feinberg School of Medicine with a focus on nutrition and obesity, acknowledges that people with obesity deal with a range of social stigmas. “The stigmatization and discrimination of people who are overweight is rampant in health care, the media, and society at large,” he said. 

But what happens when you lose the weight and become smaller?

Dealing With “Skinny Privilege”

The term “skinny privilege” or “thin privilege” refers to instances where you’re treated differently (usually better) when you’re thin than you are when you’re overweight. Some examples of this unique form of privilege might include:

• More people offer to help you (i.e., hold the door for you, help you with groceries, etc.)
• It’s much easier to find clothes that fit your new body size
• You suddenly get hit on or asked out on dates more frequently
• People start to compliment you on more than just your weight, like your clothing, hairstyle, and other appearance-based attributes
• Your boss or other higher-ups praise you for being a hard worker or you’re offered a raise or promotion even though your job description or position hasn’t changed
• Coworkers, family members, or friends who used to ignore you are now vying for your attention
• It feels like people listen to you when you speak and/or look you in the eyes more often than they did before you lost weight
• People who once treated you cruelly have a sudden and noticeable change of heart 

Danielle Kelvas, MD, a doctor who specializes in treating eating disorders, writes, “Because society values thinness, people in smaller bodies may experience social benefits, like making friends more easily and accessing structural advantages.”

Managing Social Changes

Regardless of how you’ve lost weight, dealing with a brand-new world of unrealized relationships and social changes is challenging. It might even make you ask yourself, Do people only value me based on how I look? What about who I am as a human being on the inside?

It’s important to note that skinny privilege can impact anyone regardless of their status or background. Omar Bazza, a Toronto-based clinical therapist, lost 45 kilograms or nearly 100 pounds and documented his experience. He wrote, “As I lost weight, somehow, people started seeing me as more competent and more hard-working, which was not true at all, given that I had to reduce my workload to better care for myself. People started engaging in conversations more and wanting me to be around.”

Self-Care Strategies for Coping

Fortunately, you can proactively dismantle the difficulties you may face while dealing with this double-edged sword of being thinner while also being treated differently than you were before.

Focus on Self-Love

Caring for yourself as a whole human being, not just your outward appearance, is vital before and after weight loss. Regardless of how people treat you now, only you have the power to determine your worth. Self-love and self-care are always important, but it’s particularly important now. Remind yourself that you’re worthy of love and respect all the time regardless of your size.

Don’t Engage

If someone is body-bashing another person, do everything you can to avoid joining that discussion. Even better, situations like this allow you to be an advocate for someone else (only if you feel comfortable taking a stand and speaking out). It’s also crucial to avoid body-bashing yourself and focus on your accomplishments and how far you’ve come instead.

Most importantly, accepting compliments from others about your weight loss in a way that redirects the focus on your hard work or yourself as a person rather than your appearance and size alone is key. This simple shift in mindset reminds others that your weight loss is much more than just shedding pounds – it’s also about your strength, determination, and resilience.

Avoid Harmful Media Narratives

From social media influencers to movie stars, society and the media tell us why we should perceive someone as beautiful and why we shouldn’t. Fashion magazines, TV shows, and even music can influence the way people view each other in real life.

This nonstop barrage of media creates harmful stigmas centered around weight. It’s best to avoid consuming this type of media if you want to cope with this complicated aspect of weight loss more effectively. Focus on friends and family, your career, a fun hobby, or how you can help others instead. 

Make Your Physical Health a Priority

Whether you’re still on a weight loss journey or you’re happy with your results, keeping your physical health at the top of your list of priorities should always be the focus. Listen to your body and make sure you’re getting vital nutrients from whole foods, plenty of good sleep, and adequate exercise. The healthier your body is, the healthier your mind will be, too.

Moving Ahead in a New Body

Being treated differently after losing weight is tough, but it’s not impossible to deal with. Ultimately, only you can determine your self-worth and how you perceive yourself. Shift your focus on what’s most important to you, and do your best to block out negative influences as you try to navigate a new world as a thinner person.

Dr. Matthea Rentea, MD, an internist and obesity specialist, sums it up beautifully: “Every day you get to decide who you want to be.”

We all think about eating to some extent—it’s crucial for life. From wondering what to eat for dinner to “how many calories is this bag of Takis?” But food noise becomes problematic if it’s so frequent and intense that it overpowers your ability to enjoy eating and daily life. Food noise is a “colloquial” term for a chronic preoccupation with food and eating.

Throughout her 20s, Janelle McCormack kept getting mixed messages – from herself.

“It felt like my mind was telling me I needed to eat to feel better, especially if I was stressed or irritated,” McCormack says. “It would give me a brief feel-good moment that didn’t last long. Then, moments later, I would feel overwhelmed with self-pity and from realizing I didn’t have control over what I craved or how much I ate.”

McCormack gained 65 pounds but says she lost much more.

“I would constantly look down on myself and mentally beat myself up over gaining so much weight,” McCormack says. “I didn’t look good in any of my outfits and became very self-conscious. I wouldn’t want to go out and socialize or dress up, and I became more of a homebody.”

McCormack, a patient of the Resurge Clinic, and Dollar, a patient with Ro, found GLP-1s helped quiet this “food noise,” improving their cravings and moods. While data on the topic is still emerging, some research (and experts) suggest that GLP-1 drugs like Wegovy and Zepbound can help reduce food noise volume so people can tune into their hunger cues.

Tell Me More About Food Noise…

Food noise is the mental chatter that causes people to focus on food and influences eating behaviors and decisions, explains Michael Glickman, MD, an obesity medicine physician and founder of Revolution Medicine. It can become so loud that focusing on hunger and fullness cues is challenging.

Dr. Glickman says food noise can include:

• Cravings
• Emotional triggers to environmental factors, like food ads or social settings
• Constant hunger cues, even when you’re physically full

Everyone thinks about food sometimes — it’s critical for survival. Moreover, seeing an ad for a specific dish and experiencing a desire to order isn’t necessarily a cause for concern.

“A little bit of food noise is needed to make informed, conscious decisions about what, when, and how much to eat,” says Cara Harbstreet, MS, RD, LD, a registered dietitian with Street Smart Nutrition. 

Signs Your Food Noise Is Too Loud

Some signs that the food noise you’re hearing is too loud include:

• Wondering if you’ve eaten “too much”
• Hearing constant mind chatter about when you will eat, did you eat enough, did you overeat, etc.
• Constantly thinking about food to the point of exhaustion and/or distress

Emerging research suggests that psychological or physiological factors may increase the volume of your food noise to louder volumes than a friend or family member who may see the same ad or experience the same life event (like planning a wedding). These factors include:

• High stress
• Poor sleep quality/duration
• Genetics
• Metabolic conditions, like polycystic ovary syndrome (PCOS)
• Some medications, including beta blockers for high blood pressure and certain antidepressants
• Physical activity levels
• Imbalance of appetite-regulating hormones, including GLP-1 

How Food Noise Affects Eating

Food noise can make the essential, cultural, and social act of eating stressful and unenjoyable.

“The constant thoughts and food noise tend to create judgment, negotiation, and fear around food,” says Amy Goldsmith, RD, a registered dietitian specializing in sports and eating disorders with Kindred Nutrition.

Food noise can contribute to various eating habits that can affect a person’s physical and mental health, experts say, including:

• Overeating: Dr. Glickman says high food noise levels can prompt impulsive and excessive eating because the intrusive thoughts make it harder to notice physical fullness or adhere to recommended portions. 
• Restriction: Goldsmith says that the guilt and shame following an episode of overeating can set off the reverse: the desire to undereat (or not eat at all). However, this can set off a binge-restrict cycle. 
• Emotional eating: Food noise might be a response to psychological triggers. However, Dr. Glickman says self-comforting with food can contribute to guilt and shame and perpetuate eating patterns that worsen mental health concerns.

Danielle Dollar’s complicated relationship with food started with insecurity as a child in foster care.

“My mom said that the first three years after I was adopted, I would ask her each morning what we were having for dinner,” Dollar says. “Thus began the food noise. As I got older, this progressed to stress eating. I would go on the right track for long periods, but stress would trigger a backslide.”

Like McCormack, the stress compounded.

“I have missed out on job interviews, social events, trying out for new opportunities, and experienced stress in my marriage,” Dollar says. “I once had a kid in middle school tell me, ‘Danielle, if you would just lose 10 pounds, you would be really pretty, and I would date you.’”

How Do GLP-1s Work to Silence Food Noise?

Dollar and McCormack say taking GLP-1s helped reduce the food noise they experienced, but how?

“GLP-1 receptor agonists or GLP-1s, such as semaglutide, are medications that help manage weight by mimicking the effects of a naturally occurring hormone called glucagon-like peptide-1,” Dr. Glickman says.

He says these drugs work to quiet food noise in many ways, including:

• Appetite regulation: Dr. Glickman explains that GLP-1s help improve feelings of fullness and satisfaction by activating GLP-1 receptors, stopping or reducing constant food thoughts and cravings.
• Reduced food intake: A person feels fuller, partly because Dr. Glickman says GLP-1s slow down stomach emptying. When food stays in the stomach longer, digestion slows, fullness increases, and the urge to eat constantly (even when you aren’t hungry) drops. 
• Behavioral and emotional well-being: Dr. Glickman says blood sugar spikes and crashes can affect mood and the desire to eat emotionally, but GLP-1s help with insulin regulation. Other research indicates that antiobesity medications might affect dopamine pathways in the brain that trigger a “reward” response during eating.

Yet, lower food noise can set off a positive cycle. Harbstreet explains that when people feel less distracted by cravings and intrusive thoughts about food, they can focus on other aspects of their lives, something McCormack found true for her.

McCormack reports that engaging in things she enjoys, like riding horses, helps prevent her from constantly thinking about food. Having broken the overeat-stress-overeat-stress cycle, she feels her mood and outlook on life are much better.

Strategies to Reduce Food Noise

GLP-1 medications are designed for long-term use and don’t make permanent biological changes.

However, it’s possible to take some steps to reduce food noise even if you’re not taking GLP-1s. Additionally, experts share people may benefit from these strategies while using the medication.

Avoid Severe Calorie Restriction

While restriction has long been billed as a way to lose or maintain weight, Harbstreet says it’s harmful. 

“With or without GLP-1s, your body still needs adequate nutrition,” Harbstreet says. “This includes energy, which is calories, and nutrients. Eating regularly might seem counterintuitive knowing that these medications suppress hunger cues, but it’s important to help you avoid potential nutrition-related issues in the future.”

Skipping meals and severe restrictions can make food noise louder. Consistent eating can have the opposite effect, preventing excessive hunger and impulsive eating later. Dr. Glickman says intense focus during the workday can dull hunger cues, so reminding yourself to eat regularly is essential. 

One of Dr. Glickman’s favorite ways to bridge the gap between lunch and dinner is quick mid-afternoon snacks like yogurt with berries and a handful of nuts.

Identify Food Triggers and Cues

GLP-1s can help lower food noise. However, Habstreet explains that they don’t always treat the root cause of the chatter, such as emotional distress. Learning triggers and cues can help you determine the support you need. For example, does emotional stress prompt intense cravings for a certain food? Do you eat more out of a specific emotion? Are there times you delay eating or don’t eat at all for some reason, and what is it? Journaling can help.

Explore Your Taste Preferences

Harbstreet says denying yourself a favorite dish can intensify food noise. Consuming meals and snacks you like can help increase satisfaction. She says food noise levels and a person’s relationship with food can improve if you eat something you genuinely find tasty.

Harbstreet concedes that this tip can be a slippery slope toward binge eating, and working with a registered dietitian or therapist can be helpful. 

Pause

Food noise can be so loud it causes you to continue to eat when you’re no longer hungry. Goldsmith says that taking a beat to tune into your body by assessing your hunger on a scale throughout meals and snacks can help you listen to your cues. Once you’re full, stop eating and re-assess your body’s signals in a few hours.

Slow down your eating as well. Most people eat too quickly, but slowing down by chewing each bit thoroughly can give your brain and body time to communicate and register fullness cues.

Dollar now has these conversations with her son, hoping to help him navigate food noise and body image more easily than she did.

“My 8-year-old said, ‘I’m full,’” she says, recalling a family meal. “I gently said, ‘Mason, if your tummy and brain are saying you’re full, stop eating. It’s OK. We need to learn to listen to our bodies.’”

Establish Balanced, Nutritious Eating Patterns

Dr. Glickman says a balance rich in a variety of whole foods can help stabilize blood sugar and manage hunger. He recommends consuming:

• Vegetables
• Fruits
• Lean proteins (and increasing them in general)
• Whole grains

For instance, a fiber-packed breakfast like avocado toast on whole grain sprouted bread with flax, chia, hemp seeds, and microgreens can fill a person up and lower mid-morning cravings.

Incorporate Physical Activity

Dr. Glickman says exercise is more than physical activity. It can help regulate appetite and lower stress. Gentle movement, like a brisk daily walk, might boost your mood and lower your emotional desire to eat.

Research from 2023 suggests that exercise can reduce appetite.

McCormack’s favorite ways to stay active include walking dogs and riding horses.

Develop Stress Management Techniques 

Learning to cope with stress can reduce emotional eating triggers that increase food noise. Dr. Glickman says these techniques include deep breathing and meditation exercises. For instance, he says a person might practice a relaxation or stress management technique before a meal or snack so they listen to their body’s cues and eat mindfully. 

When to Seek Support for Food Noise

While lifestyle modifications and self-help techniques can help lower food noise, people might need additional support. Harbstreet says signs you might benefit from an outside perspective to help with food noise include feelings that it is:

• Disruptive
• Overwhelming
• Distracting
• Unmanageable

A registered dietitian or therapist can help.

Registered Dietitian

Harbstreet says that registered dietitians can help you develop personalized assistance to lower food noise, including:

• Consuming adequate nutrition, with or without GLP-1 medication
• Exploring taste preferences 
• Identifying food triggers and hunger cues
• Screen for eating disorders or eating disorder behaviors

Harbstreet says some insurances cover sessions with a registered dietitian, and healthcare providers can give referrals to one.

Therapy

Working with a behavioral therapist can help reduce food noise, address underlying mental health concerns contributing to it, and help people develop coping skills to manage both. Food noise is still an emerging topic. However, Dr. Glickman and research indicate that therapeutic approaches that can assist with disordered eating and/or eating disorders include:

For Dollar, a focus on her mental health has been paramount to improving her physical health, even with the assistance of GLP-1s.

“I started therapy at church that encouraged me to start a journal to work out my daily thoughts,” she says. “I read now and make sure that—for the first time—I take time to myself.”

Some people geek out on new Taylor Swift albums; others geek out on new academic studies on psychiatric medications. (JK, I geek out about both.)

In late 2022, I was writing an article for this site on the latest in depression treatment. As a therapist, mental health writer, and human with treatment-resistant depression, I have every reason (literally) to stay as up-to-date as I can on treatment options for myself, my clients, readers, and friends. 

I know that SSRIs can be a real mixed bag; I’m one of the lucky one-third who has never achieved “remission.” Taking an SSRI for a gristly problem like depression is usually as effective as using a butter knife to cut a steak. Oh yeah, and if you’re lucky enough to find one that maybe kinda sorta helps your depression, you unfortunately might have a little less luck having a functioning metabolism and sex drive.

Once I got to college, though, beer pong was about as active as I got. I’m pretty sure I can actually count on one hand the number of times I went to my college’s gym, and those times were only when I was being dragged by my track-team roommate (and usually bribed with a snack afterward.) 

I ate and drank to hide from my feelings about being away from home, feeling overwhelmed, and having social anxiety. As the number on the scale rose, so did the amount of food and booze I consumed to deal with that. Every Sunday night, after yet another weekend of more of the same, “tomorrow” was forever the day I was going to change my life.

The First Weight Loss

Plot twist: the actual day I changed my life for the first time was a Tuesday. One of my high school besties had asked me to be her bridesmaid for her wedding in Aruba. Two years older than me, MaryBeth was always my “cool” friend. 

With that event looming, I decided I needed to fit in—literally. My weight had crept up to a number I was incredibly uncomfortable with. I didn’t want to be memorialized in her wedding photos forever looking like that, or—worse—feeling as though I didn’t fit in.

I started a blog called “Losing Weight in the City” to document my decision, hoping to kill two birds with one stone—keeping myself accountable along the way as well as sharpening my digital skills while I was bored to tears at a legal magazine. I ended up losing 50 pounds, slowly but surely.

I knocked those birds dead, and forged a new identity for myself: fitness blogger and marathoner. Eventually, I even changed the name of my blog to “Preppy Runner” to reflect that the “losing” period was over, and I now identified as a runner.

I was invited to VIP fitness events, and I wore Equinox’s “It’s Not Fitness, It’s Life” t-shirt completely unironically. Along the way, I even picked up several fitness certifications (personal trainer, yoga teacher, running coach), credentials that would bolster my authority and further cement myself as a fit person—right?

I, too, have read all the same studies you probably have about how likely we are to regain the weight after a big loss like that, but I vowed that I would be the exception, and I joined the National Weight Control Registry, a longitudinal study on people who have been successful in losing weight.

The Gain

For years, I was successful at keeping the weight off. Even through my mom’s first bout of cancer, I still maintained the goal weight I had achieved through my blog. 

But when her cancer came back—just four months after we got that magical “in remission” news—so, too, did every last one of the 50 pounds I’d originally lost. Some crept on in that initial aftermath; others joined in the wake of the global pandemic.

Although of course, I beat myself up for a lack of “willpower,” Hui (“Christina”) Wang, LCSW, clinical social worker in the Center for Weight Management and Metabolic Health at Cedars-Sinai says that “longitudinal studies indicate that PTSD may lead to increased BMI, for potentially up to two-thirds of all women with PTSD.”

Even knowing that, though, was a tough shot to take. Learning that, I felt both vindicated and shamed all at once. Some of the studies—as well as what I’ve learned in my schooling—point to both behavioral and biological changes.

Behaviorally, I was trying my best to continue my healthy habits, and it’s hard for me to fight the biological factors that trauma activates, such as the increased cortisol levels that lead to higher rates of belly fat. Fun!

Plus, as the traumas piled on in my life, so, too, did the amount of actual psychiatric medication I swallowed every morning just to get through the day and maybe make it to the next one. But, as anyone who has had suicidal thoughts, when you’re feeling that way, you only really care about what you’re eating once you’ve eaten too much and can add it to the list of reasons you suck.

The Decision

When my psychiatrist told me in 2022 that she’d heard at a conference that early reports were saying that weight loss medications might also be “neuroprotective,” I pretended to be casually interested, but I was secretly floored. 

By that point, I’d been unhappy with my weight—again—for at least the previous six years. Much like anything else I’d enjoyed in my life before my mom died, it didn’t feel like I’d ever get back to a place where I was happy with my body for how it looked and how it functioned.

Many of my lab results were beginning to veer into the unhealthy categories. Running and my other favorite activities felt unreasonably hard. As someone who’s 41 years old and who’s already lost one parent and is serving as a caregiver to the remaining one, I am absolutely terrified of my own health declining prematurely.

But even beyond that, I have a hard time believing I can do things, much less ever do them well. As you might guess, that attitude thwarts…a lot, including trying to do something like losing weight that comes with such a built-in high failure rate and requires a lot of consistency on a day-to-day basis.

Earlier this year, I found myself sinking into another true depressive episode, and it seemed like all the tools I had at my disposal (SO many tools; remember, I’m a therapist now too!) were just the wrong ones for the job. I felt incredibly stuck in my life and had a hard time moving forward in almost every area. 

My psychiatrist and I discussed some medication options, and one of the medications she suggested was one I’d taken before and that I knew caused sluggishness and weight gain for me. That was a big “HELL NO” moment. Fatigue and brain fog are two of my most annoying symptoms and anything that might contribute to that and cause weight gain? Nope.

Here I was, unhappy with my weight AND depressed, and there was something that could help me feel more comfortable in my body again….yet I was self-stigmatizing. The reasons were myriad: I “knew better,” taking this drug was “giving up,” and “What would people think?”

I worried that after writing about fitness and mental and physical health for the past 15 years, people would see me as a sham or that I’d taken the easy way out if I was using a medication to help me lose weight. Yet, I’m (mostly) OK with being a therapist who also needs to take psychiatric medication.

Taking the Plunge

Like a good therapist, I gave this problem some thought and decided to work past my own fears and negative self-talk and take positive action. Ultimately, I decided, if one of these medications wasn’t for me, I could eliminate it, no harm, no foul.

My psychiatrist said that while she fully supported my taking the medication, she didn’t want to prescribe it since she didn’t consider herself an expert. While I understood that reaction, I hadn’t banked on it, and I found myself freaking out that now that I’d decided I was ready to take it, I wouldn’t be able to find someone to prescribe it to me.

But I had a few things working in my favor: 

• While I believe that the Body Mass Index (BMI) is a pretty BS metric, my starting BMI did fit the clinical criteria for obesity, so I was easily able to get a prescription
• Although my insurance hasn’t covered it, I am lucky enough to be able to afford to pay the out-of-pocket price that is still exorbitantly high, despite the manufacturer’s coupon
• The popularity of GLP-1s

A family member had recommended a telehealth service, and within 24 hours, I had my prescription. That was exactly seven months ago to the writing of this article, and I don’t regret my decision for a second.

Changes in Mind and Body

I’ve faced numerous new and bigger challenges in my life since starting this medication, and I feel like I have been able to take them in stride in a way I never have before. Plus, I’ve found it easier to keep up with my healthier habits.

With that said, it hasn’t been all puppies and sunshine. Some of those side effects you hear are true, and my digestive system reacted to both extremes during my first month as my body adjusted to the medication.

But considering I’ve also been on both psychiatric and non-psychiatric medications that caused suicidal ideation, some digestive distress was annoying and anxiety-provoking, but relatively easy to deal with in comparison. (Though, I did have two major trips within a few months of starting the medication that caused significant anxiety for me over how my body would react away from home.)

While the phrase “food noise” reads a little bit too much out of Big Pharma marketing copy for me to personally use, I didn’t even notice how omnipresent it was until it was turned down from a scream to a low hum. I didn’t realize how I’d judge nearly every piece of food I put in my mouth and every workout I did and didn’t do. 

Thankfully, while fitness was a huge key to losing weight the first time, it’s been a long time since I’ve associated my workouts with aesthetics. (Which is good since apparently abs are made in the only kitchen I’ve never been able to find.) Nope, my workouts are first and foremost for my sanity, then my overall health, with my appearance being pretty close on my priority list.

With that being said, while my weight didn’t necessarily influence the workouts I did do pre-GLP, it absolutely influenced the workouts I didn’t do because I didn’t feel confident in my body, both aesthetically and functionally. I was absolutely shocked the first time I surfed after starting the medication—about six weeks in—and how easy it was to hoist less body weight up onto my big piece of foam in the ocean.

Letting People In

My relationship with GLP-1 medications was a bit like a new relationship. At first, I wanted to hide it to keep it safe from opinions.

After all, after spending my entire life on two different sides of the weight spectrum, I was skeptical to think that this time would “stick.” Wouldn’t this just be like any other thing I’d tried? Something that would work for a while but inevitably weight would come back.

But as time went on and it felt like this was gonna be A Thing, I started letting people into the circle. First in was obviously other friends and family members whom I knew were using the medication themselves or had struggled with weight themselves. They would be a sympathetic and safe audience. 

Next in were friends who were medical or allied health professionals whose objectiveness I hoped I could count on. 

However, I modeled what I always tell my clients to do if they feel I’ve misunderstood them, and I let her know that I’d felt really judged and unheard. Although I would have preferred to not have had that experience with my therapist, I always say that therapy is a microcosm of “real life,” and it was good practice for any future judgments. 

Finally, I let almost everyone in. I’ve lost a significant amount of weight at this point, and I believe it’s fairly noticeable—at least, I’ve been told it is. 

Releasing the Shame

A handful of people have asked me how I did it, and at first I would completely shrug off the question, choosing to change the subject instead. I wasn’t ready to share my secret until I felt more solid with it. 

I first realized that—for me—I had to tell people what I was doing when I mentioned to a friend that I’d been on it, and she mentioned that she’d noticed that I’d lost weight and had started comparing her willpower to how she imagined my willpower was.

As someone whose small amount of career success is related to what I’ve shared online, I often think how I’ll share a big decision or event online. When I started this medication, I vowed that while I wasn’t going to make some big proclamation that I was starting it, I also wasn’t going to lie if anyone asked what I’d been doing. My reasoning: I didn’t want someone comparing themselves to a version of me that didn’t exist. That is, someone who lost all of this weight based on “willpower” alone.

Willpower is a finite resource, which is why most weight loss attempts are ultimately unsuccessful. Additionally, as the other factors in your brain and body stack against you, that willpower becomes even harder to tap into.

Plus, as a society, I’m glad that we’re realizing that whether or not one loses weight isn’t as black and white as “Do they have the willpower or not?” That ignores the bigger systems that created the myth that weight loss is just about willpower.

Keep in Mind

I know that GLP-1s aren’t for everyone—AND I also want people to understand more about the whys behind someone choosing to take a medication like this. For anyone reading this who’s been considering these medications, I hope this article helps you feel less alone. I’ve seen a lot of physical and mental improvements since beginning the medication, but at the end of the day, it’s just another tool to help me reach my goals.

With millions of Americans taking GLP-1 medications for weight loss, the thought of taking one of these medications might have crossed your mind.

Maybe you’ve heard some of the more extreme stories in the media about gastroparesis (delayed emptying of the stomach) or people vomiting in workout classes, and you’re terrified that will be you. Or you’re worried about being on medication for the rest of your life. All of your concerns are valid.

It’s also important to be sure you feel confident in whoever is managing your care while on one of these medications. With the growing popularity of GLP-1s, there are plenty of less-than-scrupulous practitioners just trying to make a buck off a trend.

What You Might Feel Pre-GLP-1

For starters, if you’re considering taking a GLP-1, there are two crucial things you need to know: you are not a failure, and taking this medication (or not!) doesn’t change anything about who you are as a person.

Similarly to an antidepressant, statin (cholesterol-lowering drugs), or blood pressure medication, it is just one more tool to help you improve your health.

And if you’re reading this particular article on this website, maybe either you or a loved one deals with a mental health condition. You may be judging yourself about your weight, your mental health condition, or both. 

The Metabolism and Mental Health Connection

But you might find some comfort in knowing how interconnected metabolic and mental health issues can be. In so-called modern healthcare, our different body systems are often treated as totally separate entities that don’t interact at all, when that couldn’t be further from the truth. Metabolism and mental health have a bidirectional influence on each other.

So, if you’ve struggled with your weight, it’s likely that you’ve also dealt with one or more mental health conditions. And if you were affected by childhood adversity—already putting your health at risk for other conditions— metabolism was likely altered at a young age as a result.

Even controlling for other risk factors such as gender, race, family history, or lifestyle choices like diet and exercise, those exposed to childhood adversity were predisposed to obesity over their peers who weren’t.

Similarly, a major study of more than 100,000 women showed that those who experienced post-traumatic stress disorder (PTSD) symptoms also had their BMIs increase more rapidly than those who hadn’t.

Behaviorally, these changes can also lead to trouble controlling appetite and using food and alcohol to cope with their symptoms of PTSD.

In terms of treating both, it doesn’t necessarily matter which caused the other, says Hui “Christina” Wang, LCSW, clinical social worker in the Center for Weight Management and Metabolic Health at Cedars-Sinai. “We usually tackle it all at once. Patients who have had metabolic issues and issues with their body also often find their depression harder to handle.”

And depression—particularly treatment-resistant depression (TRD)—and obesity have shared biological mechanisms. Though there are still few biomarkers for TRD, C-reactive protein is typically elevated in people with TRD, similarly to people dealing with obesity.

What Happens To Your Mental Health When You Take a GLP-1 Medication?

While you’re on a GLP-1 medication, you may experience some mental health benefits—and that’s not just because you’re happy with reaching your health goals. Since GLP-1 medications regulate metabolic hormones, it tracks that those more stable hormone levels would also lead to an increase in our feel-good hormones, too.

“I’ve seen the joy that folks have had,” says Wang. ”Body image may be a big change, but what I hear more of is the increase in energy levels and improving other conditions. It actually rarely is about appearance.” 

Although most of the research linking GLP-1 medications with positive mental health outcomes is still in its infancy, researchers are learning that these medications can play a role in the management of conditions including depression, PTSD and preventing cognitive decline.

Anecdotally, people on GLP-1 medications report less desire for alcohol, and some research also shows that these medications could play a role in the treatment of alcohol use disorders and other addictions. Partially, this is because alcohol may cause nausea while on these medications, but also because the reward-seeking signals in the brain are turned down. It may even prevent relapse drinking.

And as someone who started one of these medications myself partially to deal with my own treatment-resistant depression and its associated weight gain, I’m finding this personally true. 

But saying no to the second drink that turns into a third that turns into…well, you get the picture…has been an act of mind over matter. Being on one of these medications has made it so much easier for me to decide whether I actually want the taste of the alcohol or not—and I usually don’t now, something that would have absolutely shocked me 10 years ago. 

However, it’s not all puppies and sunshine for everyone. While many people experience anti-depressant-like effects, others will find an increase in anxiety because of how GLP-1 medications affect serotonin, similarly to how some people will experience this uptick after starting a selective serotonin reuptake inhibitor (SSRI) for depression.

What Happens to Your Mental Health After You Stop Taking a GLP-1 Medication?

At this writing, there is no consensus on whether everyone who starts a GLP-1 medication needs to take it for the rest of their lives to maintain their weight, but studies suggest a lifetime maintenance dose might be required.

“Obesity is a disease that needs to be managed for the rest of your life,” says Rachel Goldman, PhD, FTOS, “and that management may include a GLP-1, another medication, another form of treatment, or even a combination of treatments.

However, for many, the decision may be out of your hands due to finances/insurance or even supply issues. Either way, whether you’re on one of these medications or considering it, you’re likely wondering about how your body and brain will react after you stop taking them.

The cravings may come back, according to preliminary research, though it seems like the longer you have been on the medication, the less likely/less intense this may be. Additionally, Wang says that she’s seen that patients who are honest—with both themselves and her—about their weight loss hurdles pre-medication are the ones who tend to do the best after they have discontinued the medication.

How to Cope With the Different Stages

As someone who’s on one of these GLP-1 drugs myself, I understand all too well some of the things you may be feeling before, during, and after this process, and I want you to know that you’re not alone.

Just the idea of taking this medication may be bringing up many feelings—and the process can be gratifying and also emotionally complicated—so I advise finding a trusted mental health professional (preferably one who specializes in the treatment of obesity, health behavior change, body image, or disordered eating behaviors) to help you work through these changes and stages: 

• Before: Be sure you have a good support system in place, including both personally and with your clinical support team. Wang says that she sees her patients with the best outcomes are those who have strong habits in place and who are in psychotherapy to work on body image and confidence 
• During: Have realistic goals and expectations. Wang says a big factor she needs to work on with her patients is expectation management. “A lot of folks feel like they’re not losing weight fast enough,” she says. Especially as these medications become more popular and widely-taken, it is human nature to want to achieve similar results to our peers. However, we’re all starting from different places both physically and mentally.
• Post: If you do find yourself gaining some weight back or some cravings returning, be gentle with yourself as well as being honest and upfront with your healthcare providers about your concerns.

When it comes to weight loss, it seems everyone has an opinion on what works best. Right now, the opinions about weight loss medications are all over the place. Many find the new antiobesity medications an amazing tool for the treatment of obesity, while others claim it’s a “crutch.” 

Jennie Stanford, MD, an obesity medicine physician, says GLP-1 receptor agonists work by targeting specific hormones in the gut that increase fullness, promoting weight loss. “GLP-1 receptor agonists should be considered as part of a longer-term weight management strategy.” Dr. Stanford explains that while weight loss medications may help you lose 10 pounds quickly, “using them for short-term, small volume weight loss may backfire in terms of weight regain.” 

I read a recent Facebook post from someone considering GLPs to help with losing the 10 pounds they gained over the summer. They decided against using the medications, but not because they didn’t meet the criteria for the prescription, all they needed to do was “clean up” their diet.

And that’s where the stigma and shame about using weight loss medications come into play. We feel shame when we lack the willpower to eat better, so we have this internal debate about whether or not we should use weight loss medications. But this kind of thinking only compounds the issue, causing negative thoughts and feelings that trigger overeating, reducing your motivation. 

But the decision to take antiobesity medications is between you and your doctor. It’s a personal choice and one that should consider your physical and emotional needs. Let’s take a look at some of the things you might want to consider before considering antiobesity medications.

Managing Changes in Energy Levels

As Dr. So pointed out, fatigue is an unfortunate side effect of antiobesity medications. Folks using GLP-1 receptor agonists say that over time they can predict when the drug will hit and zap their energy. Though the timing of the energy drain differs, users of the medications say they may feel tired on the first day of the injection or the fatigue may strike a few days after. 

Planning your injection around your schedule may help to avoid low energy from disrupting your routine. After a while, people taking the GLP-1 receptor agonists find the side effect improves over time. If you are experiencing low energy or fatigue as a result of these medications, you have some options. One option may be changing medications, such as going from Ozempic to Monjauro, which can be discussed with your prescribing physician.

What Happens to Your Social Life

“So you might not want to go out to eat as much with your friends, and when you do, you probably won’t eat as much as you previously did,” according to Meghan Garcia-Webb, MD, a board-certified internal medicine, lifestyle medicine, and obesity medicine physician in Boston, Massachusetts. 

Dr. Garcia-Webb says you may not find food, or alcohol, as entertaining as you once did and you may want to find other ways of socializing that don’t revolve around food. 

Don’t worry, your social life isn’t over. You can still enjoy going out to eat, but you may have to think differently about how or what you order. Maybe sharing a meal with a friend or just ordering an appetizer may work for you. You can also enjoy making new memories by doing different activities with friends and family, like going on weekly hikes or joining a pickleball team. 

Should You Tell Friends and Family?

Whether you tell your friends and family is completely up to you. Your health information is personal and you don’t have to tell anyone about your weight, weight loss plans, or that you’re considering antiobesity medications. Licensed psychologist Rachel Goldman, PhD, recommends having some reflection questions to help answer some of the ones that may arise (or have some sample scripts ready to go):

• What purpose is it serving for you to share this?
• If you share this news, do you think that person would be someone who can support you on this journey?

“Since GLP-1 drugs came out, people initially were more secretive about it, but now I’m seeing people become more open and honest about being on weight-loss drugs since it’s become more common and more and more people in the media are admitting to using them,” reports Sue Decotiis, MD, an NYC-based weight-loss doctor. 

Questions and comments about your weight should be off-limits. “However, be prepared for people to comment when you lose weight, some people just can’t help themselves,” warns Dr. Garcia-Webb.

Only people knowledgeable about the medications should be asking questions, says Dr. Decotiis. Anyone taking antiobesity medications shouldn’t feel pressured to disclose their personal health information, she explains. 

Managing Opinions

Dr. Stanford reminds us that antiobesity medications are a tool for the treatment of obesity and overweight individuals with weight-related diseases like Type 2 diabetes and heart disease. These medications are reversing health problems and improving wellness and well-being. 

It’s important to always remember why YOU are taking these medications. Regardless of what others may say, you know you made the right choice for yourself. “It is amazing how some people feel entitled to comment on someone’s weight, but at the end of the day, it has nothing to do with you. Just stay focused on your own health journey and what’s right for you,” says Dr. Garcia-Webb.

The main concern with opinions, judgment, and shame is that it may derail treatment. “If people’s judgments are preventing a patient from properly taking the drug, drinking enough water, and eating the right nutrients, that can be a major problem,” says Dr. Decotiis. 

You can’t change how someone thinks or feels and some people may make remarks that are inappropriate. Dr. Decotiis reminds her patients that they came to see her for a reason, it’s not just about weight loss, but gaining control over their health. 

How Others Can Support

Having the support of a team of wellness experts who can help you make the necessary lifestyle changes is essential for reaching your health goals, whether you take antiobesity medications or not. 

When speaking to your doctor, Angel Luk, RD, a registered dietitian and co-founder of FoodMysteries.com, says it’s important to talk about the pillars of obesity management with your doctor: nutrition therapy, physical activity, behavior modification, and medical intervention.

All of these factors need to be part of your plan so you can succeed. You may also find it helpful to connect with support groups. Talking, learning, and sharing with those who are struggling with similar issues can help you feel less alone.

How to Wean Off Old Coping Behaviors

All of our experts agree that lifestyle is the most important part of your weight management program. Creating healthy habits is how you reach your goals and stay there.

Lifestyle modifications should be recommended before medication, says Dr. Sanford. One should assess their current food intake, physical activity, sleep, stress, and alcohol intake to come up with a plan with their healthcare provider.

Making small, manageable changes is a good place to start, says Luk, offering specific suggestions such as:

• Eating your first meal within two hours of waking
• Spacing your main meals every four hours
• Finding ways to add daily movement into your day in a sustainable manner (i.e. walking for at least 10 minutes after eating, aiming for 30 minutes a day)
• Building mindfulness habits around reasons for eating beyond hunger such as “eating for comfort, companionship, or as a reward”

Creating healthy, sustainable lifestyle habits and ways to cope is essential for anyone considering weight loss medications, even those who only want to lose small amounts of weight, remarks, Dr. Stanford. 

Ozempic, Wegovy, Mounjaro (oh my). While GLP-1 agonists like these were originally used to manage type 2 diabetes or reduce the risk of heart attack or stroke, their popularity continues to rise since they were marketed as weight loss medications.

GLP-1 agonists work by triggering the pancreas to produce more insulin, which reduces blood sugar levels in those with type 2 diabetes by slowing digestion and causing someone to feel full for longer and less physically hungry. Additionally, they act on regions of the brain that process feelings of hunger, making someone less interested in eating—hence leading to weight loss.

Because of this effect on appetite, many people on these drugs also report a decrease in “food noise,” or intrusive, constant thoughts about food that disrupt day-to-day life and can make it challenging to be consistent with healthy eating behaviors.

Mary Claire Haver, MD, a board-certified OB-GYN and author of “The New Menopause,” explains, “We do see they are decreasing the risk of cardiovascular disease and death from CD. We are also seeing improvement in insulin resistance and fat loss. They have been helpful for those who struggled in the past and diet and exercise didn’t work.” 

While the effects of these medications can be life-changing—and even life-saving in some cases—there are still some health concerns to keep in mind. Below are some tips for nurturing your mental and physical health when taking GLP-1s. 

Go in With Realistic Expectations 

While being excited about the benefits of these medications can be motivating, it’s important to be aware of what to anticipate day-to-day. When discussing the use of the medication with your doctor, beware of what to anticipate in terms of dosing and the type of follow-up that will be involved. For example, it’s important to monitor labs to make sure that liver and kidney function are not negatively impacted. Additionally, make plans to deal with potential side effects if they do come up. 

Katelyn Miskevics, LMFT, a therapist at LifeStance Health, says, “With the recent popularity of weight loss drugs, people may think that they know what to expect based on the information they see on social media, but it’s important to do your own research if considering these medications and talking with your doctor. Without this, someone might develop unrealistic expectations or find themselves comparing their journey to someone else’s.”

She also encourages being aware of mental health challenges that could come up. “Overall, significant weight loss can bring up emotions related to feeling vulnerable and exposed, along with pressure to maintain your weight, and also what may feel like an identity crisis while adjusting to a new appearance and how others may perceive you. While losing weight quickly – especially at the beginning of your journey – may offer a sense of instant gratification, but if that naturally starts to slow down over time, someone might begin to feel disappointed.” 

Molly Carmel, LCSW, a therapist and coach specializing in eating disorders and addictions, says, “I’ve personally seen a range of outcomes with GLP-1 medications.” Carmel adds, “GLP-1 medications can be incredibly helpful, but it’s important to remember they’re not a magic fix. One common challenge is that people sometimes forget to focus on their overall health and nutrition while on the medication.”

Prioritize Your Mental Health 

Something that doesn’t get nearly enough airtime is that losing a lot of weight, especially in a short period of time, can have a huge impact on your mental health. Miskevics says, “There are a number of ways to support your mental health throughout this journey. First, do your research on the mechanism of how you will be losing weight, talk to your doctors and professionals, and set your personal intention as to why you want to lose weight.”

“Once you begin, set realistic goals to hold yourself accountable, but have some flexibility and grace with yourself if things don’t work out exactly as you imagined,” continues Miskevics. “I recommend daily journaling, ensuring you are eating healthy amounts of food and nutrients, and not fixate too much on the weight itself, but more how you feel along the way. Post-weight loss, celebrate your successes and your body for all it does for you, and don’t put too much pressure on yourself to maintain specific weight. Losing weight should be a journey that helps someone feel strong, healthy, and confident in their skin.”

While so much of the focus around these drugs in the media relates to weight loss and appearance, it’s important to remember that health is about so much more than the number on the scale. “Keep in mind,” says Miskevics, “that you will never be fully defined by your image or weight, but who you are as a person.”

Optimize Nutrition

Success on a GLP-1 is not just about eating less. Yes, eating less can lead to weight loss and related benefits, but because muscle loss is a common concern on GLP-1s—as this can negatively impact metabolic health and make it easier to regain weight when you come off of the medication—nutrition and exercise play an important role in preserving muscle mass. Negative effects on bone health and malnutrition are also complications to be aware of.  

Lauren Harris-Pincus, MS, RDN, the founder of NutritionStarringYOU.com and author of “The Everything Easy Pre-Diabetes Cookbook,” encourages considering lifestyle changes to support having the best experience possible on the medication. “GLP-1 agonist medications are only one tool in a much larger toolbox when it comes to treating overweight and obesity. Diet and lifestyle interventions are critical for success and to promote optimal health for those taking the medication. Simply consuming fewer calories and smaller portions of foods that are not nutrient-rich may lead to nutrient deficiencies and sacrifice muscle and bone health.”

She explains that good nutrition habits are essential for success when taking a GLP-1 medication. “The key is to minimize side effects and maximize the nutrition content of the foods you eat while maintaining a caloric deficit for weight loss. We need to make sure people meet their needs for protein, fiber, fluid, vitamins, and minerals which can be challenging with a significantly reduced appetite.” 

Pay Attention to Muscle Mass

We’re so conditioned to look at the number on the scale, but when it comes to healthy weight loss, it’s important not to lose too much muscle. While muscle weighs more than fat tissue, it’s more metabolically active, meaning it burns more calories at rest than fat does. So, the more muscle someone has, the higher their metabolism. Muscle loss is one of the main reasons why someone may find it so easy to regain weight loss on a calorie-restricted diet if they haven’t been conscious of incorporating habits to help retain muscle. 

Dr. Haver says, “When you lose weight through severe caloric restriction, about half of what you lose tends to be muscle mass.” To protect against muscle loss, Harris-Pincus recommends strength training and consuming adequate protein. “Currently, we don’t yet have official recommendations for protein needs specific to GLP-1s so we use information based on weight loss in general and bariatric surgery guidelines. I typically recommend 1.2 to 2 grams per kilogram of ideal body weight or about .7 to 1g per pound to help maintain muscle mass and hopefully gain some with the help of strength training exercises at least two times per week. For a baseline recommendation, I suggest 25 to 30 grams of protein per meal, especially breakfast.”

If you want to keep an eye on whether you’re losing mostly muscle or mostly fat, you can purchase a smart scale that tracks this information or use a scale in a gym or doctor’s office that measures body composition. This can help you spot when to make changes to your diet or exercise routine to better support muscle retention or offer you tangible insight into what’s working. 

Have a Plan for Managing Side Effects

While not everyone will experience the same side effects or to the same degree as others, it’s important to have a plan for how to manage them if they do come up. This helps reduce overwhelm and discomfort. 

Carmel adds that not everyone has a positive experience on GLP-1s. “I’ve also seen clients who were non-responders or who didn’t respond well and faced severe side effects like stomach paralysis or intense nausea, which made the medication unusable for them. There are also cases where I have seen people ignore the medication’s satiety signals and continue overeating. For those with a history of eating disorders or emotional struggles, I’ve observed new, obsessive behaviors related to weight and body image emerging.”

Harris-Pincus says, “The most common side effects include decreased appetite, nausea, constipation, diarrhea, and vomiting. In my experience, nausea is the most common and can be helped by limiting fat in meals, even the ‘good’ fats because they delay digestion even more. Constipation is also common and can be helped by meeting fiber goals of 25 to 38 grams per day along with hydrating sufficiently with approximately three quarts of fluid per day including water, coffee, tea, seltzer, and other unsweetened beverages.”

While this side effect is less frequently discussed, Dr. Haver shares, the mechanism that helps reduce food noise may also cause other changes in desires. “I’ve had a few patients who found that while on these medications, they lost interest in other pleasurable activities.” Don’t be afraid to talk about this with your healthcare provider and discuss the best approach to optimize your quality of life.  

Nurture Your Relationship With Food 

The journey of weight loss while taking a GLP-1 medication can be a great opportunity to improve your relationship with food. Miskevics explains, “GLP-1s may offer someone an opportunity to fast track their health goals, but I would encourage individuals taking them to also use that time as an opportunity to understand how their emotions correlate to their eating habits, and to see if they can develop a healthier dynamic with food. Try to focus a little bit less about the appearance aspect of losing weight, and challenge yourself to focus more on the positive changes felt: feeling more energized, better quality of life, creating a healthier mindset surrounding body image.”

Carmel adds, “There’s a saying: “If you want to know why you’re binging, stop binging.” When your appetite and impulses are better controlled, you might start to uncover underlying emotional issues. Addressing these through therapy, coaching, or support groups can really enhance the benefits of the medication and help if you decide to taper off – and decrease your desire to turn to food when you’re having big emotions.” 

“With the reduction in food obsession,” says Carmel, “it’s a great time to adopt habits that support mental well-being, like meditation, journaling, and breathwork. The space created by the medication can be a wonderful opportunity for emotional healing and improving mental health.”

Don’t Wait Until You’re on Medication to Start Making Changes

If you’re planning to start a GLP-1 agonist medication in the near future, Dr. Haver recommends putting some healthy habits in place now. “Start looking at your protein intake. Start resistance training.” Walking really isn’t enough, she says. “If you’re sedentary, get a weighted vest, add hand weights. If you’re already working out, get more serious in the gym.

Exercises that allow you to maintain your muscle mass are critical.” She also encourages looking at other lifestyle factors. “How’s your sleep, how’s your stress reduction? These things are also critical for reaching and maintaining a healthy weight.” 

Bottom Line

Getting the support you need, making plans to manage side effects, and exploring the emotions that come up can help you have the best experience possible when using these medications on your weight loss journey. 

Carmel says, “I encourage my clients to view GLP-1s as a helpful tool and to allow them to work on building healthy habits like meal planning, getting enough protein, and strength training. The clients who succeed are the ones who use the medication to support these healthy habits, not as a means to eat what they want.”