Anxiety in the first weeks: drug, situation, or both posts 31–60
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
I came in to disagree and I am leaving without a disagreement.
Maintenance brings a different set of psychological questions from loss, and the discussion here is much thinner on that phase.
Worth separating anxiety as a question about the compound from anxiety as a question about the documentation. They get answered by different people and only one of them is answerable here.
Mood and anxiety: mood changes and anxiety are reported by some people. Baseline mental health status matters for risk. Someone with a history of depression should plan closer monitoring.
Post #33 answers the question as asked. The question underneath it is different.
Two things can be true about anxiety at once: the mechanism is plausible and the evidence for the size of the effect is thin. Most of the argument here is people defending the first against attacks on the second.
Small correction to my own earlier position on anxiety. I had the units the wrong way round, which changes the conclusion by an order of magnitude and therefore changes it entirely.
If you are in crisis, contact a local emergency or crisis service rather than posting. A volunteer forum cannot help and waiting costs time.
I disagree with the framing of anxiety above, and I think it is a substantive disagreement rather than a terminological one. Setting out why, so it can be checked.
The reasoning depends on an assumption that is doing a lot of work and is never stated. If the assumption holds, the conclusion follows. I do not think it holds generally.
Nothing here is medical advice and several members in this subcategory say plainly that they are describing their own experience only.
Two questions I would want answered before drawing anything from the anxiety data above: how were the cases selected, and what happened to the ones that dropped out.
On anxiety the community has more anecdote than the confidence in this thread implies, and I include my own contribution in that.
That is clearer than the version I had in my head. Thank you.
Where I part company with post #40, and it is a narrow parting.
Social and relationship impacts: weight change affects how others perceive and interact with a person. Those impacts are real and can be psychologically significant.
That is all I can say without guessing.
I would keep anxiety and the decision it usually gets used for separate in this thread. They are related and they are not the same question, and merging them is why the last one went badly.
Post #44 describes the usual case. This is about the unusual one.
Maintenance brings a different set of psychological questions from loss, and the discussion here is much thinner on that phase.
Confirming post #46 from a second method, which matters more than confirming it from a second person.
Sleep and mental health: these compounds can affect sleep for some people. Sleep deprivation worsens mood and anxiety. Addressing sleep separately from mood matters.
That distinction has done more work for me than anything else in this category.
Post #46 answers the question as asked. The question underneath it is different.
Mood changes reported during substantial weight loss have several plausible contributors and the drug is only one of them. Energy restriction alone is a well-documented one.
I would put a moderate confidence on that and no more.
I have been on both sides of the anxiety argument in this category within eighteen months, which should tell you how strong the evidence for either side is.
If you are new and reading this thread for the answer to anxiety: the answer is conditional, the conditions are in the third reply, and the rest of the thread is worth skipping.
Collapsed as off-topic by two members at trust level 3 or above
Picking up post #51: that is the part I would want checked first.
The social side of this — how other people respond to visible change — comes up constantly and has nothing to do with pharmacology.
If the premise is wrong, everything after it is decoration.
I had written a reply contradicting post #51 and deleted it. Here is what survived.
Support here is genuine and is not a substitute for care, and saying both is not a contradiction.
For what it is worth, the same held on the two occasions I checked.
My position on anxiety is current rather than settled. I have revised it once already and I expect to again, so treat it accordingly.
Helpful, and short, which on this subject is harder than long.
Coming back to post #56, because the follow-up matters more than the original answer.
Motivation and expectation: starting with clear motivation and realistic expectations about what will happen and when helps with psychological adjustment.
Correct me on the arithmetic if it is wrong; I would rather know.
Post #56 is right about the mechanism and I think understates the practical bit.
Offering a way to settle anxiety rather than another opinion about it. Two measurements, taken the same way, a fortnight apart. If the difference is within the noise, the question was not answerable at this precision.
Answering the question post #56 raises rather than the one it answers.
The honest answer on anxiety is that it depends, and the useful part is the list of what it depends on. Four items, in rough order of how much they matter.
Most people get the first two right and then argue about the fourth.