- The psychological and emotional effects of significant weight loss come along with the physical benefits of taking GLP-1s.
- Experts share some of the effects to consider.
- While some changes are typical, experts share when it’s time to see a mental health professional.
While more and more studies continue to show the physical benefits provided by GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound, health experts are starting to discuss the mental health tolls that can come with rapidly losing weight while taking these drugs.
“A dramatic weight loss is a major change that happens to one’s body and, given the fact that our mind-body connection is so strong, physical changes will inevitably cause psychological changes as well,” Kate Miskevics, LMFT, a therapist at LifeStance Health, told Healthline.
Rapidly losing weight can be thought of as an adjustment period, and any adjustment that a person goes through often has a psychological and emotional component to which it takes time to adapt, said Miskevics.
On the positive side, she said dramatic weight loss can cause an increase in self-esteem and sense of accomplishment, improve a person’s quality of life, and offer new opportunities.
Those who lose weight on a GLP-1 medication may also experience a sense of relief, said Robyn Pashby, PhD, founder and director of Health Psychology Partners, and member of the National Board of Directors Obesity Action Coalition.
“Relief comes from a reduction in food noise, a sense that efforts to ‘eat less and move more,’ which has been preached to them for decades, are finally ‘paying off,’ and a sense of feeling more in control of their own bodies,” Pashby told Healthline.
While people often feel stronger, motivated, and more empowered while they are losing weight, she said weight plateaus or weight stabilization once a goal weight is reached can be frustrating.
“[All] weight loss has plateaus, and eventually weight stabilizes, and even if people are happy at that new weight initially, it can be hard to keep up the sense of empowerment and motivation,” she said.
Pashby works with clients to shift away from focusing on weight loss only to focusing on health — both physical and mental.
“Allowing people to recognize non-scale victories like a lower cholesterol number, or feeling strong while hiking on vacation, are meaningful and important outcomes,” she said.
For those who don’t respond well to anti-obesity drugs or who
“Many people already feel like a failure in not being able to manage their weight; as societal beliefs in self-control and discipline still incorrectly influence people’s understanding of weight regulation, so to use a medication that social media often portrays as being a magic cure, and to not respond, is incredibly discouraging,” Pashby said.
In general, Miskevics said anyone setting out to take medication for weight loss is still responsible for how they manage their perception of body image.
“Expecting to lose weight and automatically feel happier or more confident can be a dangerous line of thinking, as this places an emphasis on the idea that someone needs to be thin in order to be acceptable,” she said.
This is especially important in a “post-Ozempic” society, which Miskevics said seems to be slipping back into harmful standards related to glorifying thinness and the pursuit of becoming as small as possible.
“This has called into question the recent body positivity movements of the previous years, as people fear we are moving away from the acceptance of ‘all’ bodies,” she said.
However, if people can more easily reach wellness goals and anti-obesity drugs to become healthier, this can improve the quality of their life and open more doors of possibility, joy, and confidence, Miskevics added.
Most people who lose a lot of weight on a GLP-1 medication will experience body perception changes, said Pashby.
They may need to adjust to physical changes that occur with significant weight loss, like differences in skin texture and appearance, hair, and how their clothes fit. There is also processing how others react to the weight loss.
“Some will meet these changes joyfully; others will struggle with the realization that the world is kinder to people who live in smaller bodies,” said Pashby.
Realizing that overweight and obesity are complex biological conditions that require medical support and are not due to a lack of willpower is a needed shift.
“This adjustment is often the hardest because weight bias is so deeply rooted in our culture and people often have a hard time not feeling like they are ‘cheating’ by using medical support,” said Pashby.
Worrying about continued access to a GLP-1 drug that has caused weight loss or what will happen if the medication is stopped are other concepts with which Pashby sees her clients have challenges.
“And concerns about how to talk about their medication use with others (e.g., should I tell everyone that I lost weight on this medication or keep it to myself? How do I handle it if people ask me how I lost weight? Am I cheating by using this medication to lose weight?),” she said.
Miskevics encourages people to consider the following to help with significant weight loss and its effect on them mentally.
- Keep an open mind that while your body and perception of body image take shift, your weight will never define who you are as a person. “You are still you at the end of the day, and being able to accept yourself as a human goes far beyond appearance and size,” she said.
- Be aware of your ongoing relationship with food and its connection to mood. “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,” she said.
- Focus less on the appearance aspect of losing weight and challenge yourself to focus more on the positive changes felt, such as feeling more energized, having a better quality of life, and creating a healthier mindset surrounding body image.
As with most psychological constructs, Pashby said there is a wide range of individual experiences.
While most people will struggle with body image at some point in their life, she said a person should connect with a mental health professional, “if those body image concerns seem to take up a significant proportion of one’s thoughts or interfere with their ability to enjoy time with friends or family, engage in activities they would like to do (like go to the pool or beach), or if a person feels very stressed and anxious or depressed about their body.”
Pashby encourages people to seek a mental health professional earlier rather than waiting due to the following reasons.
- Finding a therapist who is available and has expertise in the particular area you need can be challenging.
- All therapists are not the same and finding a therapist with whom you feel comfortable and safe may take a few tries.
- If your body image concerns are impacting you to the point of considering seeking help, then those same concerns are likely influencing your relationships, which have an impact on your happiness, resiliency, and joy in life.
