I’m on Weight Loss Medication — and I’m Not Ashamed Anymore

Like many people, I’ve had a hard time disentangling my weight and mental health from each other; they’re inextricably linked. I grew up relatively “average-sized,” but I was always active AND athletic.

Once I got to college, though, 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, 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.”

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 knows, 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 this time, GLP-1 medications were starting to become popular. I’d resisted trying one or more of them for more than a year since my doctor mentioned that they were also being used for mental health, but as more and more friends and family started taking them, I started wondering just why I was resisting.

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,” or “taking the easy way out,” and “What would people think?”

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. As I write this article, 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. 

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 an affair. At first, I wanted to hide it to keep it safe from opinions. Things were going well, and clearly telling people would jinx that.

But as time went on and it felt like this was gonna be A Thing, I started letting people into the circle. First in were obviously other friends and family members who 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. 

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.