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Everywhere you turn, there’s a story about the potentially huge physical health benefits of using a weight-management prescription to drop pounds. These medications are called glucagon-like peptide 1 agonists, or GLP-1s, and include semaglutide (known by the names Ozempic and Wegovy and Victoza) and tirzepatide (sold as Zepbound or Mounjaro). Only Wegovy, Zepbound, and Saxenda are FDA-approved for weight loss at this time; Ozempic and Mounjaro are still technically FDA-approved only to treat diabetes, though doctors do prescribe them off-label to help with obesity. There’s no doubt that they’ve become a game changer for countless people trying to lose weight. But given the complex relationship between weight and mental well-being, it raises an interesting question: If these drugs help you shed those pounds, do they make you happier, too?
As you might expect, it’s not that simple.
“People often think if they lose weight, all their problems will be solved and they’ll be totally happy,” says Katie Rickel, Ph.D., a clinical psychologist and CEO of Structure House, a residential weight-loss center in Durham, NC. “They think, ‘I’m going to get the job I’ve always wanted, my relationship is going to get better, I’ll have more friends’—but all that doesn’t happen unless you take other steps along with the weight loss. It’s not only about losing weight.”
Still, experts working with people who have been prescribed these meds say they’ve observed numerous positive psychological benefits of taking a GLP-1 to drop pounds and get healthier. “Overall, people I work with who are on these meds have a positive experience—they’re happier because they have more energy and are sleeping better,” says Caroline Susie, R.D., a registered dietitian in Dallas, TX, focused on adult weight management and spokesperson for the Academy of Nutrition and Dietetics. The medications help cut out “food noise,” she says, which is a low-level preoccupation with food—what you just ate, what you’re going to eat later, and self-judgments about who you are based on your diet. Getting rid of that noise, agrees Rickel, can help people focus on other things. “They suddenly have more space for emotions beyond self-judgments about food,” she says.
Empowerment and confidence also tend to rise as that constant preoccupation with food—and the pounds that come with it—decreases. “Sometimes losing weight boosts someone’s confidence, and they can get out and make more friends or have new opportunities,” which can lead to even more positive feelings, says Rickel.
That being said, having negative thoughts and feelings as well isn’t uncommon when taking one of these meds. “As strange as it sounds, a lot of people experience a kind of grief,” says Rickel. When decreased cravings or appetite from the medication stops food from being as enjoyable or the comfort they’ve grown to turn to, “it can feel like a loss of a life-long friend,” she says. Additionally, though not everyone experiences side effects, GI issues like constipation, nausea, or diarrhea can happen, says Susie, leading to stress in social settings. Some people, excited by their weight loss, may also take it too far and eat too little—and start feeling like food is the enemy, says Rickel.
Still others grapple with feelings of guilt or shame when using a GLP-1. “There should not be shame in taking these medications—they’re just another tool in your weight-loss toolkit,” says Susie. “Having trouble losing weight isn’t about a lack of willpower. But I still have to explain that obesity is a disease all day, every day.” Those feelings can be heightened if friends, family, or coworkers aren’t supportive. “So much of our social culture is based around food, and when you’re making different choices about how you interact with food, people in your life may not fully understand it, or even feel rejected if you turn down a dinner invitation or food they made for you,” says Rickel.
Working through these issues takes time—and possibly the help of professionals. Susie advises meeting with a nutritionist and a therapist (in conjunction with your prescribing physician) to help make healthy choices along the way in your weight-loss journey—both in terms of the foods you eat and the way you process your emotions.
How does that translate into the real world? We asked five people currently taking obesity medications to share their insights into how they quieted their food noise, dealt with judgmental reactions from friends, and navigated some surprising emotions while adjusting to their new normal.
“I Have a Better Relationship With Friends Now.”
—Brittany Pfeiffer-Ainsworth, 39, college administrator, St. Louis, MO
Weight had been a challenge for Brittany Pfeiffer-Ainsworth her entire life. Overweight as a child, she had disordered eating habits as a teen and became obese as an adult. In 2016, she found out she not only had type 2 diabetes but also polycystic ovary syndrome (PCOS), which made weight loss feel nearly impossible. “I could only lose weight if I went on a restrictive no-carb or very low-carb diet and exercised almost nonstop,” she says. “Plus, the food noise was loud and constant. There was no getting away from it. I could manage it intermittently, but it always crept back in, and I fell into the same habits.”
She’d previously taken dulaglutide for her diabetes but decided to try tirzepatide after noting its potential weight-loss benefits. She’s been on the medication since January 2023 and has lost 104 pounds.
Pfeiffer-Ainsworth’s experience so far has been mostly positive. She feels free from food noise and enjoys social outings more than before because she’s not stressed about what she’s eating. “I have better relationships with friends and family than I have in years because I’m not removing myself from the fun or retreating into the background,” she says.
The current shortage of the meds she’s on has caused her some stress, says Pfeiffer-Ainsworth, and she’s worried that taking semaglutide in the meantime won’t be as beneficial for her since she hasn’t tried it yet. “This medication has given me my life back and allowed me to view food in a completely different light,” Pfeiffer-Ainsworth says. “I’ve now put a strong system of calorie counting and exercise almost daily into place, so I’m confident in my own abilities as well.”
“I’m Healing My Relationship With Food.”
—Merris Taylor, R.D., 32, dietitian, Beaumont, TX
“I’ve always struggled with food and overeating but was able to maintain my weight with extreme willpower and prescription ADHD medication,” says Merris Taylor, who was diagnosed with attention deficit/hyperactivity disorder (ADHD) when she was 21. But when she decided to go off her ADHD meds in her mid-20s, while simultaneously dealing with some personal challenges, including a couple of tough break-ups and the death of her father, Taylor started gaining weight and never stopped. After hitting her highest weight ever last year, and dealing with both PCOS and osteoarthritis, she decided to try an obesity medication. “I knew I needed to get the extra weight off my bones,” she says.
She started with semaglutide but experienced all side effects and no weight loss. “That was discouraging, and I almost gave up,” she says. She turned to tirzepatide the next month, in June 2023, and it immediately lessened her food noise with minimal, manageable side effects. Before taking meds—she’s now on a tirzepatide compound, because the lower dose seems to work better for her—Taylor says her relationship with food was rocky. “I loved food and used it for comfort when life was hard,” she says. “I really don’t have an off switch when it comes to eating. I would try to lose weight but never could stick with it because the hunger and food noise would increase.”
Taylor says she loves feeling more in control since quieting the food noise. “I’m still working on healing my relationship with food after many years of yo-yo dieting,” she admits. “I still eat emotionally sometimes, but I don’t feel anxiety about eating since being on the meds.” Taylor says it’s been a little surprising to discover she still doesn’t totally love the way her body looks, even though she’s dropped 50 pounds in the past 10 months. “I’m thankful for my body and like it better than before, but there will always be some insecurities,” she says.
“I’m Still Working on Body Acceptance.”
—Lili Zarghami, 47, editorial strategist and founder of Jenny magazine, Brooklyn, NY
After being on the slimmer side as a kid, Lili Zarghami started having weight concerns as a teen. “As soon as puberty hit, weight started accumulating in the middle of my body,” she says. “I’ve probably wanted to lose weight, on and off, since then. I’ve never felt like I’m the weight I ‘should’ be.”
Despite having healthy food habits (she avoids fast food, processed foods, and snacking) and exercising regularly, Zarghami has struggled to shed weight because she has PCOS. “Food is not the problem for me—it’s my hormones and metabolism,” she says. She decided to try an obesity medication in 2023 following a 20-pound gain in one year. “I was excited because I’d seen so many success stories from people who sounded like they experienced the same thing I did: doing the right things and having no luck,” she says. “But I was also nervous, because I’m always nervous taking any drug—you never know how they will affect you.”
After her first injection, she lost all desire to eat. What initially felt exciting, though strange and foreign, suddenly took a more serious turn. After the second week, she started having extreme muscle fatigue and couldn’t do her normal daily activities. “It felt like I was starving without ever having felt hunger,” she remembers. “My body was crying out for help, but I physically couldn’t make myself eat food. It felt as if my stomach had been removed and there was nowhere for the food to go. It was a tortured feeling to know I needed to eat but couldn’t.” She ended up at the ER and then in urgent care, and eventually decided to stop the meds altogether. This episode fed into the fear that she was failing somehow. Why wasn’t this medication working for her?
“I knew the only way I could eat again was if I stopped taking the drugs,” says Zarghami, who’d expected some mild GI side effects but felt blindsided by the way the medication affected her mentally. “I wouldn’t describe it as relief but a desperate attempt to keep living. I was eager to stop but also deeply disappointed that I couldn’t keep taking the medication. It was the most wicked catch-22. I’d dropped 11 pounds in two weeks, and it felt like the medication had made my body do what it was supposed to be doing. But it also felt like it was also trying to kill me.”
Zarghami has considered trying another medication but worries GLP-1s might just not be for her. “I was too traumatized to try another right now,” she says. The experience did underscore something Zarghami thought to be true: that there’s something wrong with her body. “It just doesn’t work the way it should, and it’s not my fault,” she says. “I haven’t gotten to body acceptance because I don’t want to have the body I have, but I do accept it’s not my fault now.”
“I Can Enjoy Food and Not Feel Shame About It.”
—Jake Parshall, 29, art director for an ad agency, Detroit, MI
“I’ve always loved food—cooking and trying new food—but before the medication, it was an obsession,” says Jake Parshall, who has struggled with obesity for years. “If I ate something salty, then I ate something sweet. And then I’d have to eat something salty again. I was constantly thinking about food.”
He decided to start using an obesity medication in April 2023 through WeightWatchers Clinic after experiencing “a lot of failure losing weight every other way I tried,” he says. Almost immediately his preoccupation with food lessened and he felt much more in control. “It’s empowered me to try food but not overeat and make myself sick and feel like I need to eat everything,” says Parshall, who’s lost a little more than 100 pounds in the past year. “For the first time in a long time, I can let myself enjoy the things I love, like sweets, and not feel shame about it.”
His mother and husband had both been taking GLP-1 meds for a while before he started, says Parshall, which made the transition to his new normal “super positive and supportive.” Knowing that there’s still a stigma about taking drugs for obesity, he does pause when coworkers ask questions about how he’s losing weight. “I definitely feel the stigma and only share certain things with people I know well and am comfortable with,” he says.
Parshall says that he’ll occasionally crave something that will now make him feel nauseous—like fried foods—and feeling like his body doesn’t tolerate it anymore can be frustrating. But he says he wouldn’t trade his current state for the world. “I thought that compulsive drive to think about food and eating was baseline normal; I didn’t know everyone doesn’t think like that,” he says. “Overcoming that has been amazing and revolutionizing. I feel like I’m in the driver’s seat and have control for the first time ever.”
“I’ve Come So Far.”
—Janelle McCormack, 32, X-ray tech, Stephenville, TX
In her late 20s, Janelle McCormack went through a stressful time and put on about 60 pounds, going from 130 to 194. “In addition to the stress and unhappiness, I was then also beating myself up for gaining this weight,” McCormack recalls. Despite trying vegetarian, ketogenic, and low-carb diets, she couldn’t lose the weight after trying for two years. After starting to work for the Resurge Clinic in Weatherford, TX, (which focuses on weight loss and other wellness specialties) and getting blood work that showed she was prediabetic, McCormack decided to try an obesity medication to help her lose weight.
When she didn’t see any difference the first two months on her meds, McCormack got discouraged. “I blamed myself when I didn’t lose weight right away and got depressed,” she remembers. She felt self-pity and stress-ate. But two months in, the pounds started coming off. “All of a sudden, the food noise and cravings were gone. It was so exciting.”
Navigating social outings has been tricky at times. She often meets friends at a wine bar but now frequently sticks to only one glass of wine and a couple bites of food. Some of her friends have been a little judgmental about why she eats less, says McCormack: “They’ll ask, ‘What’s wrong with you? You never turn down food.’ I feel some shame about that but tell myself, they’ve never struggled with weight and the kind of intense cravings I deal with.”
Since starting obesity meds, McCormack has dropped 60 pounds and is no longer prediabetic, and her new weight lets her ride horses—one of her favorite hobbies—more comfortably. Her weight now fluctuates from about 135 to 142, and she admits it can feel discouraging when she’s on the high end of that range. “Some days I feel extremely bloated and can feel a little disgusted that I’ve let weight creep back on,” she says, acknowledging that her emotions are still very much tied to her weight. “But then I think, no. I’ve come so far. I look at older pictures to remind myself how far I’ve come.”
This article was originally published April 2, 2024 and most recently updated May 20, 2024.
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