This is a profoundly important point. I want to highlight it:

For many patients with obesity, disordered eating behaviors serve as coping mechanisms for underlying anxiety, depression, trauma, or emotional dysregulation. When GLP-1 RAs remove the food-seeking behavior, the underlying condition can surface — sometimes dramatically.

This is why I advocate for psychological support as a standard component of GLP-1 therapy, not an afterthought. A therapist familiar with eating disorders and weight management can be invaluable during this transition.

Additionally, the FDA does require monitoring for suicidal ideation with GLP-1 RAs as a class. While the data has NOT shown an increased risk of suicidality in trials, the regulatory concern reflects the acknowledgment that these drugs affect brain function. If anyone experiences suicidal thoughts, please reach out to the 988 Suicide and Crisis Lifeline immediately.

this thread is making me feel so seen. i've been on tirz for 6 weeks and i've been crying at random things — commercials, songs, my dog looking at me funny. i thought i was just hormonal but the timing tracks with the medication start. it's not debilitating but it's definitely different from my baseline.

going to bring it up at my next appointment. thank you for normalizing this conversation. 💙

Thank you all. I spoke with my psychiatrist yesterday and we're increasing my sertraline to 150 mg. She also brought up the absorption concern and suggested I take the sertraline on an empty stomach first thing in the morning, 30 minutes before eating, to maximize absorption before any GLP-1-related gastric effects kick in.

Also going to look into therapy specifically for the emotional relationship with food. The point about food being a coping mechanism that's suddenly been removed really resonated. This is so much more than a weight loss journey — it's a complete rewiring of how I interact with one of the most fundamental aspects of being alive.