An estimated one in eight U.S. adults have used GLP-1 agonist medications, according to a survey by the health policy research organization KFF released in May 2024. Traditionally used for treating diabetes or preventing cardiovascular events in those with heart disease, these medications are increasingly popular for weight loss. Notably, 22% of those taking these medications reported being diagnosed with overweight or obesity by their doctor within the past five years.
Healthcare providers are increasingly treating overweight and obesity as medical conditions, emphasizing that a person “has” these conditions rather than “is” these conditions. This is akin to how we talk about other medical conditions, such as diabetes or heart disease.
There are numerous reasons someone might seek to lose weight, including reducing disease risk, alleviating weight-related issues such as joint pain and sleep apnea, and improving health markers. Even a modest 5% weight loss can enhance cardiac health. GLP-1 agonists assist weight loss by stimulating the pancreas to produce more insulin, thereby lowering blood sugar levels in those with Type 2 diabetes and promoting satiety.
Medically assisted weight loss is gaining traction, complementing traditional diet and exercise interventions. While some view these medications as groundbreaking, others are skeptical, citing potential side effects such as nausea, vomiting, diarrhea, increased heart rate, acute kidney injury, and pancreatitis.
One appeal of these medications is their rapid efficacy compared to diet and exercise alone. However, rapid weight loss can lead to muscle mass loss, potentially weakening metabolic health. The mental health implications of significant weight loss are often overlooked.
Mental Health Considerations
Kate Miskevics, LMFT, a therapist at LifeStance Health, highlights the varied mental health impacts of significant weight loss. “When approached healthily, dramatic weight loss can boost self-esteem, provide a sense of accomplishment, and improve quality of life, potentially alleviating anxiety and depression,” she says.
However, challenges can arise. “Dramatic weight loss can stir emotions related to vulnerability, pressure to maintain weight, and an identity crisis while adjusting to a new image,” Miskevics adds.
The mental health impact also depends on whether weight loss is gradual or sudden. Rapid changes can be more challenging to adjust to. Gradual weight loss allows more time to process and adapt to a changing body. Miskevics emphasizes the importance of mental preparation regardless of the weight loss method.
Kim Shapira, a dietitian and author, stresses fostering a healthy relationship with food. “The goal should be a normal relationship with food, which can help maintain weight loss,” she says. For those struggling with binge or emotional eating, weight loss medications can quiet overeating triggers. However, Shapira notes the importance of addressing emotional needs to maintain healthy weight loss over time. Mindfulness can help build awareness and reframe thoughts that lead to unhealthy eating behaviors.
Unique Mental Health Challenges of Weight Loss Medications
Weight loss medications present specific mental health challenges, including coping with drastic weight loss, managing side effects, and the financial burden of long-term medication use. Regaining weight after stopping medication can be mentally taxing, underscoring the need for a comprehensive weight loss plan incorporating nutrition and exercise counseling.
Miskevics points out the societal trend and media coverage surrounding weight loss medications like Ozempic and Wegovy, which can lead to misinformation and unrealistic expectations. “It’s crucial to research beyond media to avoid disappointment and anxiety if results differ from expectations,” she advises.
Mindset Tips
Miskevics recommends reflecting on mental health needs before starting a weight loss journey. Questions to consider include: What is my main intention for losing weight? How will I respond to comments about my weight loss? How can I hold myself accountable while practicing self-compassion?
Shapira advises taking a long-term view. “Success hinges on seeing oneself as a hero capable of self-healing,” she says. She encourages considering non-scale victories, such as reduced intrusive thoughts about food and improved emotional regulation.
Bri Blank, founder of Bri Healthy, emphasizes loving one’s body throughout the weight loss journey. “Seeing yourself at different weights can be challenging. Active self-love is crucial,” she says.
Arash Hashemi, co-founder of Kaizen, shares the importance of aligning internal identity with physical transformation. “Weight loss brings positive changes, but reconciling self-perception requires conscious effort and patience,” he notes.
Supporting Mental Health
Miskevics suggests making a plan, setting realistic goals, and being flexible. Tracking thoughts and feelings through journaling, ensuring adequate nutrition, and focusing on how one feels rather than weight alone are essential. Talking with a therapist can provide support and coping strategies.
Blank highlights the transformative power of meditation. “Meditation helps me stay calm and less reactive,” she says. Hashemi advises focusing on overall well-being and celebrating small victories. “Weight loss is about more than the scale; it’s about feeling confident and healthy,” he says.
Ultimately, Miskevics reminds us that weight loss is a journey towards feeling strong, healthy, and confident. “Your value stems from who you are, not your weight. Celebrate progress and maintain balance in life,” she concludes.
