Table of ContentsView AllTable of ContentsTurning to GLP-1sComplicated EmotionsWeight Loss and Increased AttentionExtreme Weight Loss May Influence Body DysmorphiaStaying Mentally WellNext in GLP-1s and Mental Health GuideWeight Loss Isn’t an Invitation to Comment on My Body
Table of ContentsView All
View All
Table of Contents
Turning to GLP-1s
Complicated Emotions
Weight Loss and Increased Attention
Extreme Weight Loss May Influence Body Dysmorphia
Staying Mentally Well
Next in GLP-1s and Mental Health Guide
Close
Kristin DiBiase struggled with obesity her entire life. In sixth grade, she weighed 212 pounds and went on her first diet and nutrition plan after she attended a weight management session at her local hospital in St. Louis.
“By 11th grade, I leaned out a little because I had a growth spurt. At that point I was in size XL,” says DiBiase.
When she went away to college in 1999, she gained a lot of weight. She was also diagnosed with depression during her first semester. “I was really having difficulty with my mental health,” she says.
As she navigated her mental health, she continued to work on losing weight. During her junior year, she lost 40 pounds on the Atkins diet. But gaining and losing weight became a vicious cycle from that point forward. She went on to lose significant weight five times with different diets, including BistroMD, Weight Watchers, HCG diet, Nutrisystem, and Beach Body. “For me, it’s keeping the weight off that’s an issue,” says DiBiase.
In 2012, she underwent bariatric surgery in hopes of keeping weight off. To prepare for surgery, she lost 40 pounds. After surgery, she lost an additional 40 pounds. “That is a sub-par result. Many people usually lose 100 pounds in the year after surgery,” she says. “I put everything into this and followed all protocols. For me, all the effort and resources I poured into this was disappointing.”
NoteFor some people, even losing that 40 and 40 again, is a success, although it was disappointing for DiBase.
Note
For some people, even losing that 40 and 40 again, is a success, although it was disappointing for DiBase.
On November 17, 2022, DiBiase started taking the GLP-1 medication Mounjaro off-label for the treatment of metabolic syndrome, a cluster of conditions, including obesity and high blood pressure, that increases the risk of heart disease, stroke, and diabetes.
In 2008, during adepressive episode, DiBiase’s doctor suggested she undergo genetic testing, which revealed she had serotonin deficiency.
“The source of my health issues and obesity is rooted inneurotransmittersdue to me having a serotonin issue, so I thought Mounjaro would be good,” she says.
Serotoninis a neurotransmitter that helps to regulate mood and emotion.
Since taking the medication, DiBiase has lost more than 41% of her body weight and is maintaining her body weight at around 145 pounds.
“I got results immediately,” she says. “I constantly had food noise in the background around when can I eat again and preoccupation with food. Within a week of being on Mounjaro that was gone…I was in shock and almost didn’t have words to describe how I didn’t have to think about food anymore.”
NoteIf you are currently taking or planning to take a weight loss medication, keep in mind that results may differ for each individual—for many people it could take weeks before they really see results.
If you are currently taking or planning to take a weight loss medication, keep in mind that results may differ for each individual—for many people it could take weeks before they really see results.
Losing Weight Comes With Complicated Feelings
In other words, people may expect weight loss to ‘solve’ other struggles they have, but it rarely has that outcome in the long run.—ROBYN PASHBY, PHD
In other words, people may expect weight loss to ‘solve’ other struggles they have, but it rarely has that outcome in the long run.
—ROBYN PASHBY, PHD
Ethan Lazarus, MD,past president of the Obesity Medicine Association and owner of Clinical Nutrition Center, says unexpected consequences of losing weight can range from feeling uncomfortable with newfound attention to mental health conditions from surgery or antiobesity medication.
“It is possible that people can become clinically depressed or even have suicidal thoughts,” he says. “Patients and their families should be counseled that if this were to happen, they should seek immediate treatment.”
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see ourNational Helpline Database.
On a positive note, he adds that people who lose a lot of weight might have more energy, feel less pain, and are able to accomplish more. They may also have newfound motivation and confidence.
“People realize if they can lose weight they can do anything! They quit a bad job, or assertively request a long-earned promotion. They motivate those around themselves in a positive way, ‘If I can get healthier, you can too,’” says Lazarus.
Less Weight Can Bring More Attention From Others
“Therefore, some improvements in self-esteem may come from experiencing lessweight-based discrimination,” she says. “Obviously, weight-based discrimination and bias are harmful and people shouldn’t have to fit into a societal standard to experience improvements in self-esteem.”
While DiBiase has experienced more attention from men at her current weight, she says she doesn’t let it bother her. Plus, she is happily married.
People shouldn’t have to fit into a societal standard to experience improvements in self-esteem.—ROBYN PASHBY, PHD
People shouldn’t have to fit into a societal standard to experience improvements in self-esteem.
“When I was younger and on the scene with my friends, I would encounter a lot of men who you could tell had written me off cause they were not physically attracted to me cause I was a big girl. But I have a fun personality and mentally they were attracted to me so you could see the wheels turning in their minds; it was such a conundrum and they didn’t know what to do,” she says.
Today, she saysinteractions are different because of her weight. However, instead of being mad or annoyed, she takes a practical approach. “I realized people are attracted to who they are attracted to. I’m not going to take on being pissed because there’s stuff I’m not attracted to—we all have our own preferences and it sucks if they don’t line up but that’s kind of pragmatically how I approach everything in life,” she says.
Caring for Your Mind and Body While Taking a Weight Loss Medication
After losing weight, a person’s views on body image and self-esteem often change.
Loose skin or other skin texture issues can be one source of negative thoughts after weight loss and can negatively affect body image and self-esteem, she adds.
For some people, even after losing a lot of weight, they don’t feel like they look any different. This is sometimes referred to as “phantom fat syndrome” or “ghost fat.”
DiBiase relates. Because her weight fluctuated over the years, she had a closet full of clothes in different sizes. As she began to lose weight quickly while taking Mounjaro, it took her a while to process fitting into smaller sizes.
“There was a lot of dissonance because I’m standing in an outfit that is visually too big in a mirror but I…look at myself and still feel like I’m way larger than I actually was,” she says. “It was really unsettling in a way.”
Her feelings are common, says Lazarus. “For years they have been dissatisfied with their bodies, now they lost the weight, they are still just as dissatisfied,” says Lazarus. “Oftentimes we blamed the weight, but perhaps there are other things we should be looking at—therapy (individual or couples therapy, for example) can be very helpful in these situations.”
There was a lot of dissidence because I’m standing in an outfit that is visually too big in a mirror but I…look at myself and still feel like I’m way larger than I actually was,—KRISTIN DIBIASE
There was a lot of dissidence because I’m standing in an outfit that is visually too big in a mirror but I…look at myself and still feel like I’m way larger than I actually was,
—KRISTIN DIBIASE
Rachel Goldman, PhD, FTOSexplains how much of this has to do with the way our brain has perceived and viewed us for all these years. “Unfortunately their brain can’t adjust as fast as their body has and therefore, they may continue seeing the person in the larger body, although there is evidence that they have lost weight and their body has changed,” says Goldman.
She continues: “I recommend that whenever people’s automatic thoughts is that they are still at x weight, or in the larger body, to pause and examine the evidence. Remind themselves of all of the changes, including perhaps how their clothing size has changed, they are now able to climb the stairs without getting out of breath, etc. Sometimes trying on the larger size that they were and seeing how it is now too big on them is a wonderful reminder, but couple that with self-talk. The more they remind themselves of this, the easier it will become and it will help retrain their brain. Just as their brain learned, and got used to the image it saw before, it can relearn a new image—it just takes time so you need to be patient and consistent.”
DiBiase was able to recognize that what she was seeing was not reality. She continuously reminded herself that she had clothes falling off her that were too tight a few months earlier and that the scale was showing significant weight loss.
“That’s what I did to get myself out of this and to remind me that my brain is telling me things that aren’t real,” she says.
How to Stay Mentally Well After Significant Weight Loss
As people lose significant weight while taking anti-obesity medications like GLP-1s, the followinghealthy habitscan help them process the mental health effects.
If you or a loved one are coping with an eating disorder, contact theNational Eating Disorders Association (NEDA) Helplinefor support at1-800-931-2237.For more mental health resources, see ourNational Helpline Database.
If you or a loved one are coping with an eating disorder, contact theNational Eating Disorders Association (NEDA) Helplinefor support at1-800-931-2237.
3 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alenina, Klempin F.The role of serotonin in adult hippocampal neurogenesis.Behav Brain Res. 2015;277:49-57. doi:10.1016/j.bbr.2014.07.038Food and Drug Administration.Update on FDA’s ongoing evaluation of reports of suicidal thoughts or actions in patients taking a certain type of medicines approved for type 2 diabetes and obesity.Souza ALL, de Souza PM, Mota BEF, et al.Ghost fat: altered female body perception after bariatric surgery.Percept Mot Skills. 2023;130(1):301-316.
3 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alenina, Klempin F.The role of serotonin in adult hippocampal neurogenesis.Behav Brain Res. 2015;277:49-57. doi:10.1016/j.bbr.2014.07.038Food and Drug Administration.Update on FDA’s ongoing evaluation of reports of suicidal thoughts or actions in patients taking a certain type of medicines approved for type 2 diabetes and obesity.Souza ALL, de Souza PM, Mota BEF, et al.Ghost fat: altered female body perception after bariatric surgery.Percept Mot Skills. 2023;130(1):301-316.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Alenina, Klempin F.The role of serotonin in adult hippocampal neurogenesis.Behav Brain Res. 2015;277:49-57. doi:10.1016/j.bbr.2014.07.038Food and Drug Administration.Update on FDA’s ongoing evaluation of reports of suicidal thoughts or actions in patients taking a certain type of medicines approved for type 2 diabetes and obesity.Souza ALL, de Souza PM, Mota BEF, et al.Ghost fat: altered female body perception after bariatric surgery.Percept Mot Skills. 2023;130(1):301-316.
Alenina, Klempin F.The role of serotonin in adult hippocampal neurogenesis.Behav Brain Res. 2015;277:49-57. doi:10.1016/j.bbr.2014.07.038
Food and Drug Administration.Update on FDA’s ongoing evaluation of reports of suicidal thoughts or actions in patients taking a certain type of medicines approved for type 2 diabetes and obesity.
Souza ALL, de Souza PM, Mota BEF, et al.Ghost fat: altered female body perception after bariatric surgery.Percept Mot Skills. 2023;130(1):301-316.
Meet Our Review Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?HelpfulReport an ErrorOtherSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?HelpfulReport an ErrorOtherSubmit
What is your feedback?
