Why I'm No Longer Ashamed to Admit I'm on a Weight Loss Medication

Some people geek out on new Taylor Swift albums; others geek out on new academic studies on psychiatric medications. (JK, I geek out about both.)

In late 2022, I was writing an article for this site on the latest in depression treatment. As a therapist, mental health writer, and human with treatment-resistant depression, I have every reason (literally) to stay as up-to-date as I can on treatment options for myself, my clients, readers, and friends. 

I know that SSRIs can be a real mixed bag; I'm one of the lucky one-third who has never achieved "remission." Taking an SSRI for a gristly problem like depression is usually as effective as using a butter knife to cut a steak. Oh yeah, and if you’re lucky enough to find one that maybe kinda sorta helps your depression, you unfortunately might have a little less luck having a functioning metabolism and sex drive.

Once I got to college, though, beer pong was about as active as I got. I’m pretty sure I can actually count on one hand the number of times I went to my college’s gym, and those times were only when I was being dragged by my track-team roommate (and usually bribed with a snack afterward.) 

I ate and drank to hide from my feelings about being away from home, feeling overwhelmed, and having social anxiety. As the number on the scale rose, so did the amount of food and booze I consumed to deal with that. Every Sunday night, after yet another weekend of more of the same, “tomorrow” was forever the day I was going to change my life.

The First Weight Loss

Plot twist: the actual day I changed my life for the first time was a Tuesday. One of my high school besties had asked me to be her bridesmaid for her wedding in Aruba. Two years older than me, MaryBeth was always my “cool” friend. 

With that event looming, I decided I needed to fit in—literally. My weight had crept up to a number I was incredibly uncomfortable with. I didn’t want to be memorialized in her wedding photos forever looking like that, or—worse—feeling as though I didn’t fit in.

I started a blog called "Losing Weight in the City" to document my decision, hoping to kill two birds with one stone—keeping myself accountable along the way as well as sharpening my digital skills while I was bored to tears at a legal magazine. I ended up losing 50 pounds, slowly but surely.

I knocked those birds dead, and forged a new identity for myself: fitness blogger and marathoner. Eventually, I even changed the name of my blog to "Preppy Runner" to reflect that the "losing" period was over, and I now identified as a runner.

I was invited to VIP fitness events, and I wore Equinox's "It's Not Fitness, It's Life" t-shirt completely unironically. Along the way, I even picked up several fitness certifications (personal trainer, yoga teacher, running coach), credentials that would bolster my authority and further cement myself as a fit person—right?

I, too, have read all the same studies you probably have about how likely we are to regain the weight after a big loss like that, but I vowed that I would be the exception, and I joined the National Weight Control Registry, a longitudinal study on people who have been successful in losing weight.

The Gain

For years, I was successful at keeping the weight off. Even through my mom’s first bout of cancer, I still maintained the goal weight I had achieved through my blog. 

But when her cancer came back—just four months after we got that magical "in remission" news—so, too, did every last one of the 50 pounds I’d originally lost. Some crept on in that initial aftermath; others joined in the wake of the global pandemic.

Although of course, I beat myself up for a lack of "willpower," Hui (“Christina”) Wang, LCSW, clinical social worker in the Center for Weight Management and Metabolic Health at Cedars-Sinai says that "longitudinal studies indicate that PTSD may lead to increased BMI, for potentially up to two-thirds of all women with PTSD."

Even knowing that, though, was a tough shot to take. Learning that, I felt both vindicated and shamed all at once. Some of the studies—as well as what I've learned in my schooling—point to both behavioral and biological changes.

Behaviorally, I was trying my best to continue my healthy habits, and it's hard for me to fight the biological factors that trauma activates, such as the increased cortisol levels that lead to higher rates of belly fat. Fun!

Plus, as the traumas piled on in my life, so, too, did the amount of actual psychiatric medication I swallowed every morning just to get through the day and maybe make it to the next one. But, as anyone who has had suicidal thoughts knows, when you’re feeling that way, you only really care about what you’re eating once you’ve eaten too much and can add it to the list of reasons you suck.

The Decision

When my psychiatrist told me in 2022 that she’d heard at a conference that early reports were saying that weight loss medications might also be “neuroprotective,” I pretended to be casually interested, but I was secretly floored. 

By that point, I’d been unhappy with my weight—again—for at least the previous six years. Much like anything else I’d enjoyed in my life before my mom died, it didn’t feel like I’d ever get back to a place where I was happy with my body for how it looked and how it functioned.

Many of my lab results were beginning to veer into the unhealthy categories. Running and my other favorite activities felt unreasonably hard. As someone who's 41 years old and who's already lost one parent and is serving as a caregiver to the remaining one, I am absolutely terrified of my own health declining prematurely.

But even beyond that, I have a hard time believing I can do things, much less ever do them well. As you might guess, that attitude thwarts…a lot, including trying to do something like losing weight that comes with such a built-in high failure rate and requires a lot of consistency on a day-to-day basis.

Earlier this year, I found myself sinking into another true depressive episode, and it seemed like all the tools I had at my disposal (SO many tools; remember, I’m a therapist now too!) were just the wrong ones for the job. I felt incredibly stuck in my life and had a hard time moving forward in almost every area. 

My psychiatrist and I discussed some medication options, and one of the medications she suggested was one I’d taken before and that I knew caused sluggishness and weight gain for me. That was a big “HELL NO” moment. Fatigue and brain fog are two of my most annoying symptoms and anything that might contribute to that and cause weight gain? Nope.

Here I was, unhappy with my weight AND depressed, and there was something that could help me feel more comfortable in my body again….yet I was self-stigmatizing. The reasons were myriad: I “knew better," taking this drug was “giving up,” and “What would people think?”

I worried that after writing about fitness and mental and physical health for the past 15 years, people would see me as a sham or that I'd taken the easy way out if I was using a medication to help me lose weight. Yet, I'm (mostly) OK with being a therapist who also needs to take psychiatric medication.

Taking the Plunge

Like a good therapist, I gave this problem some thought and decided to work past my own fears and negative self-talk and take positive action. Ultimately, I decided, if one of these medications wasn’t for me, I could eliminate it, no harm, no foul.

My psychiatrist said that while she fully supported my taking the medication, she didn’t want to prescribe it since she didn’t consider herself an expert. While I understood that reaction, I hadn’t banked on it, and I found myself freaking out that now that I’d decided I was ready to take it, I wouldn’t be able to find someone to prescribe it to me.

But I had a few things working in my favor: 

• While I believe that the Body Mass Index (BMI) is a pretty BS metric, my starting BMI did fit the clinical criteria for obesity, so I was easily able to get a prescription
• Although my insurance hasn’t covered it, I am lucky enough to be able to afford to pay the out-of-pocket price that is still exorbitantly high, despite the manufacturer’s coupon
• The popularity of GLP-1s

A family member had recommended a telehealth service, and within 24 hours, I had my prescription. That was exactly seven months ago to the writing of this article, and I don’t regret my decision for a second.

Changes in Mind and Body

I've faced numerous new and bigger challenges in my life since starting this medication, and I feel like I have been able to take them in stride in a way I never have before. Plus, I've found it easier to keep up with my healthier habits.

With that said, it hasn’t been all puppies and sunshine. Some of those side effects you hear are true, and my digestive system reacted to both extremes during my first month as my body adjusted to the medication.

But considering I’ve also been on both psychiatric and non-psychiatric medications that caused suicidal ideation, some digestive distress was annoying and anxiety-provoking, but relatively easy to deal with in comparison. (Though, I did have two major trips within a few months of starting the medication that caused significant anxiety for me over how my body would react away from home.)

While the phrase “food noise” reads a little bit too much out of Big Pharma marketing copy for me to personally use, I didn’t even notice how omnipresent it was until it was turned down from a scream to a low hum. I didn’t realize how I’d judge nearly every piece of food I put in my mouth and every workout I did and didn’t do. 

Thankfully, while fitness was a huge key to losing weight the first time, it’s been a long time since I’ve associated my workouts with aesthetics. (Which is good since apparently abs are made in the only kitchen I’ve never been able to find.) Nope, my workouts are first and foremost for my sanity, then my overall health, with my appearance being pretty close on my priority list.

With that being said, while my weight didn’t necessarily influence the workouts I did do pre-GLP, it absolutely influenced the workouts I didn’t do because I didn’t feel confident in my body, both aesthetically and functionally. I was absolutely shocked the first time I surfed after starting the medication—about six weeks in—and how easy it was to hoist less body weight up onto my big piece of foam in the ocean.

Letting People In

My relationship with GLP-1 medications was a bit like an affair. At first, I wanted to hide it to keep it safe from opinions.

After all, after spending my entire life on two different sides of the weight spectrum, I was skeptical to think that this time would “stick.” Wouldn’t this just be like any other thing I’d tried? Something that would work for a while but inevitably weight would come back.

But as time went on and it felt like this was gonna be A Thing, I started letting people into the circle. First in were obviously other friends and family members whom I knew were using the medication themselves or had struggled with weight themselves. They would be a sympathetic and safe audience. 

Next in were friends who were medical or allied health professionals whose objectiveness I hoped I could count on. 

However, I modeled what I always tell my clients to do if they feel I’ve misunderstood them, and I let her know that I’d felt really judged and unheard. Although I would have preferred to not have had that experience with my therapist, I always say that therapy is a microcosm of “real life,” and it was good practice for any future judgments. 

Finally, I let almost everyone in. I’ve lost a significant amount of weight at this point, and I believe it’s fairly noticeable—at least, I’ve been told it is. 

Releasing the Shame

A handful of people have asked me how I did it, and at first I would completely shrug off the question, choosing to change the subject instead. I wasn’t ready to share my secret until I felt more solid with it. 

I first realized that—for me—I had to tell people what I was doing when I mentioned to a friend that I’d been on it, and she mentioned that she’d noticed that I’d lost weight and had started comparing her willpower to how she imagined my willpower was.

As someone whose small amount of career success is related to what I’ve shared online, I often think how I’ll share a big decision or event online. When I started this medication, I vowed that while I wasn’t going to make some big proclamation that I was starting it, I also wasn’t going to lie if anyone asked what I’d been doing. My reasoning: I didn’t want someone comparing themselves to a version of me that didn’t exist. That is, someone who lost all of this weight based on “willpower” alone.

Willpower is a finite resource, which is why most weight loss attempts are ultimately unsuccessful. Additionally, as the other factors in your brain and body stack against you, that willpower becomes even harder to tap into.

Plus, as a society, I'm glad that we're realizing that whether or not one loses weight isn't as black and white as "Do they have the willpower or not?" That ignores the bigger systems that created the myth that weight loss is just about willpower.

Keep in Mind

I know that GLP-1s aren't for everyone—AND I also want people to understand more about the whys behind someone choosing to take a medication like this. For anyone reading this who's been considering these medications, I hope this article helps you feel less alone. I've seen a lot of physical and mental improvements since beginning the medication, but at the end of the day, it's just another tool to help me reach my goals.