When Food Is No Longer Your Friend: The Emotional Side of GLP-1 Medications

By Madeline Goodman, D.O., Diplomate, American Board of Psychiatry and Neurology

GLP-1 medications have been a game changer for many—especially individuals with conditions like cardiac disease, where weight loss is not just helpful but medically urgent. Patients taking certain psychotropic medications  who have experienced significant weight gain have also benefited from these medications, offering a much-needed option for weight management that doesn’t require stopping effective psychiatric treatment. The ability to reduce appetite and promote steady weight loss can significantly improve cardiovascular outcomes and reduce long-term health risks. This makes these medications a potentially life-saving option for some patients, and their medical impact should not be underestimated.

GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have been truly transformative for many people—helping with weight loss, blood sugar control, and overall metabolic health.

As a psychiatrist, I’m not against these medications—in fact, I’m very much in favor of them for the right patients. But they’re not for everyone, and like any powerful tool, they come with layers that extend beyond the physical.

This post explores some of the mental health implications I’ve seen in patients using GLP-1s—not to deter, but to add depth to the conversation. Because while appetite may go away, the emotional reasons we eat often don’t—and those deserve just as much attention.

1. When Food Was a Friend—and Suddenly Isn’t

Many of us develop a long-standing emotional relationship with food. It’s comfort, company, celebration, or stress relief. So when GLP-1 medications reduce appetite so drastically that meals feel like a chore, it can stir up feelings of loss, disorientation, or even grief.

I’ve had patients describe it as “losing their best friend,” or “feeling like they don’t know themselves anymore.” This is a valid emotional response—and one that deserves support, not shame.

For some, the grief can be profound. If a tough day used to end with a comforting meal or favorite snack, and that ritual suddenly disappears, it can feel as though a reliable coping mechanism is gone. That loss can feel overwhelming at times—not unmanageable, but difficult at best. Acknowledging this grief is the first step toward replacing it with healthier, more sustainable sources of comfort.

2. Nutrition Still Matters—Even If You’re Not Hungry

One of the most common issues I’ve seen is inadequate nutrition, especially protein. When appetite drops, it’s easy to eat very little—but without enough protein and hydration, people can feel weak, irritable, or even depressed.

In fact, when nutrition suffers, depression can re-emerge, often presenting with psychomotor slowing, low energy, and even brain fogginess. These symptoms may not always be immediately linked to food intake, but they are critical to address.

These medications are tools—not magic—and the body still needs fuel to function well. I often encourage patients to work with a registered dietitian or nutritionist, even if weight loss isn’t their only goal.

3. Emotional Eating Doesn’t Magically Go Away

Even when hunger signals disappear, emotional eating patterns remain. You might not feel hungry, but you may still feel lonely, bored, or anxious. That drive to soothe through food can come back suddenly, especially if the medication is paused or stopped.

This is why therapy, self-awareness, and building alternative coping strategies are still crucial. GLP-1s can remove the cue (hunger), but they don’t erase the conditioning or emotional patterns. The groundwork still needs to be done.

4. It’s a Personal Choice—Not a Shortcut

I never tell someone whether GLP-1s are “right” or “wrong” for them. It’s a deeply personal decision—influenced by medical needs, emotional history, lifestyle, and goals.

What I do encourage is informed use: knowing what you’re signing up for, not just physically but emotionally. Support from your medical provider, therapist, or support group can make the difference between feeling isolated versus empowered.

Closing Thoughts:

GLP-1 medications can be incredibly helpful, and I’ve seen many patients benefit greatly. But for long-term success—emotionally and physically—it’s important to do the inner work, too. Understanding why we overeat, how we soothe ourselves, and what role food plays in our lives is essential, whether or not we’re on medication.

You deserve more than weight loss—you deserve peace with your body, your mind, and your relationship with food.

About Dr. Goodman: Dr. Madeline Goodman, is a board-certified psychiatrist offering compassionate, personalized Telepsychiatry to adults across Maine. She specializes in treating anxiety, depression, trauma, and emotional eating. Learn more at www.drmadelinegoodman.com

Telehealth and Psychiatry After September 2025: What You Need to Know

By Madeline Goodman, D.O., Diplomate, American Board of Psychiatry and Neurology

Over the past few years, telehealth has transformed how we deliver psychiatric care—making it more accessible, convenient, and patient-centered. Understandably, many patients have asked me: “Will telehealth still be covered after the pandemic?” Now that the COVID-19 public health emergency (PHE) has ended, there’s some confusion about what’s changing—and what’s here to stay.

I want to offer clarity and reassurance for my current and prospective patients throughout Maine.

✅ The Good News: Psychiatric Telehealth Is Here to Stay

Telehealth for behavioral health services, including psychiatry, is now permanently allowed under Medicare and most commercial insurance plans. This means you can continue to:

  • Have psychiatric appointments from the comfort of your home
  • Use video or audio-only (phone) for sessions if needed
  • Receive care no matter where you live—no rural or in-office requirements
  • Get help with medication management, therapy, or evaluations without needing to travel

This applies to:

  • Initial psychiatric evaluations
  • Follow-up medication management (E/M visits)
  • Psychotherapy
  • Substance use disorder treatment

⚠️ What Might Change—But Doesn’t Affect Psychiatric Care

There’s been talk about a “telehealth cliff” happening on September 30, 2025, when many of the temporary pandemic-era telehealth rules are scheduled to expire. This change could impact:

  • General medical care via telehealth (like primary care or non-psychiatric specialty visits)
  • Restrictions returning around where patients must be located (e.g., rural areas only)
  • Limitations on which providers can bill via telehealth

But none of that applies to psychiatric services. Psychiatry and behavioral health are exempt from this rollback.

🧭 What This Means for You

If you’re receiving psychiatric care through my practice—or looking for a new provider who offers telehealth—you can feel confident knowing that this mode of care is fully supported and secure moving forward. I will continue offering virtual psychiatric care across the state of Maine, and I’ll always stay current with policy updates to ensure continuity of care.

💬 Have Questions?

If you’re unsure about your insurance coverage or whether a telehealth appointment is right for you, feel free to reach out. I’m happy to answer your questions and guide you through the process.

About Dr. Goodman
Madeline Goodman, D.O., is a board-certified psychiatrist offering personalized telepsychiatry services throughout Maine. Her practice focuses on compassionate, evidence-based care with flexible virtual access.

Why Telehealth Etiquette Matters: Creating a Safe and Stable Space for Therapy

online counseling session

Telehealth is Convenient — But It Still Deserves Respect

One of the great advantages of telehealth is flexibility: you can receive care from virtually anywhere. But just because you can take a session from your car, your workplace, or the corner of a grocery store parking lot doesn’t mean that you should.

As a psychiatrist and psychotherapist, I show up at the same time every week from a private, quiet, and professional space—because that’s what good care requires. And for therapy to really work, patients need to do the same.

What Good Telehealth Etiquette Looks Like

  • Be in a stationary location. If you’re in your car, that’s fine—but please don’t be driving. Pull over and park so you can give your full attention to the session.
  • Find a private space. Therapy often involves talking about personal and emotional topics. It’s hard to feel safe and open if you’re worried about being overheard or interrupted.
  • Be on time. Just like an in-person appointment, punctuality matters. It honors the therapeutic process and allows us to use the full time we’ve set aside.
  • Try to use the same place each week. Predictability creates a sense of safety, and therapy works best when we’re grounded—not scrambling to find a quiet corner at the last minute.

Why It Matters

When patients show up in a distracted, chaotic, or rushed way, therapy simply can’t unfold the way it’s meant to. Insight, reflection, and emotional growth require presence. When sessions feel disorganized or squeezed between other obligations, the space we need to do meaningful work gets lost.

Therapy is a commitment—not just to the appointment time, but to yourself.

Setting the Frame Is Part of My Job

Part of my responsibility as a provider is to help set the frame for therapy. That includes creating consistency, offering structure, and communicating expectations clearly.

If at any point something doesn’t feel clear, or if you’re unsure why a certain aspect of etiquette matters, I want you to know that it’s okay to ask. And if I haven’t said it directly—I’ll own that. I don’t expect patients to automatically know how therapy works. That’s part of what I’m here for.

Final Thought

Telehealth has opened up access to care in wonderful ways. But it’s still real therapy. The more seriously you take the setting, the more you get out of it.

As your provider, I’m here—every week, in a consistent and grounded space. I invite you to meet me there, in every sense of the word.

 

Friendships: A Reason, a Season, or a Lifetime

Why Some Friendships Don’t Last Forever

 There’s a phrase I’ve always found comfort in: *people come into our lives for a reason, a season, or a lifetime*. The older I get—and the more I work with people navigating change, grief, and personal growth—the more I see how true this is.

Friendships don’t always last forever. Sometimes they drift, or end abruptly, or slowly fade away without closure. That can feel painful, confusing, or even like a failure. But when we look more closely, many of these connections served a purpose—some we can name, and some we may only recognize in hindsight.

Friendships That Serve a Purpose: A Reason

Some friendships arrive when we need support, encouragement, or guidance. Maybe it’s the friend who helped you through a breakup. The colleague who stood by you during a hard year. The neighbor who brought soup when your world was falling apart. These are connections that often burn bright but brief. Their role was to help us in a specific moment—and that’s okay.

When Life Aligns: A Season of Connection

Then there are friends who walk with us for a chapter of life. College roommates, coworkers at a job we’ve long since left, neighbors we once saw every day. These relationships are often rich and meaningful, shaped by shared routines or life stages.

Some of the deepest friendships I’ve experienced were with other parents while raising children. In those years, our lives were so interwoven—playdates, school events, late-night texts about fevers or frustrations. We leaned on each other. We trusted each other. We often became each other’s chosen family.

But children grow up. People move. Marriages change. And suddenly those connections can loosen, or even disappear. Not out of conflict—just out of the natural evolution of life. It can feel bittersweet. A little like leaving a job you once loved, or saying goodbye to a neighborhood where you knew every face.

When a Friendship Circles Back Later in Life

I remember one friendship from my internship in Michigan—someone I met during that intense and transitional time. She wasn’t in medical training with me, but she became a deeply important part of my life. We were there for each other in a way that only happens during vulnerable chapters. After several years, I moved to Washington, D.C., for a more competitive residency, and the relationship quietly faded. I hoped it would continue, but it didn’t—at least not then.

Years later, she reached out again. The intensity we once shared wasn’t there, but the warmth was. It reminded me that even a “seasonal” friendship can carry echoes of a deeper bond. And sometimes, unexpectedly, a season can circle back into our lives. Maybe not in the same way—but still with meaning. Still with love.

Lifelong Friends: The Ones Who Stay

And then—if we’re lucky—we have the lifetime friends. The ones who know the whole messy, beautiful story. They evolve with us. Forgive. Celebrate. Show up. We don’t need a dozen of these to feel fulfilled; even one or two can be a gift beyond measure.

Short Friendships Can Still Be Transformative

It’s important to honor the connections that were brief but still meaningful. A friendship doesn’t have to last decades to be “real.” Sometimes, even a short-lived bond can be healing, joyful, or transformative.

One walk. One conversation. One season of being truly seen.

Instead of only mourning what ended, we can ask: *What did I learn from this person? How did they shape me? What will I carry forward because of them?*

Letting Go of Friendship Without Guilt

Friendship changes can be hard, especially when we feel left behind or unsure why it ended. But with time, we can hold the gratitude and the grief together. We can wish people well—even from afar—and release the idea that every connection must be lifelong to be valuable.

Final Thoughts on the Changing Nature of Friendship

You don’t have to hold on forever for something to matter. Some friendships were never meant to be permanent—they were meant to be powerful. And they were

Therapy isn’t just for bad weather

Therapy Isn’t Just for Bad Weather

When spring arrives and the long Maine winters give way to sunshine and warmth, it’s tempting to step back from routines that feel “heavy” — like therapy. Life feels lighter, moods lift, and we find ourselves outdoors more. It’s understandable. But therapy isn’t just for stormy seasons.

In fact, some of the most meaningful work in therapy happens when we’re not in crisis.

Why Summer Can Be an Ideal Time for Growth

When we’re not in survival mode, we can reflect more deeply. We can ask:

  • Who am I becoming?
  • What habits do I want to reinforce?
  • How do I build on the progress I’ve made?

Without the emotional urgency that comes with winter blues or life stressors, summer gives us space to explore.

Skipping Sessions Can Disrupt Momentum

Taking a break may feel harmless, but therapy often builds on itself. Each session adds to the last, and gaps in treatment can slow or even reverse progress. If you’ve worked hard to get where you are, summer might be the time to solidify that progress — not pause it.

Therapy Isn’t Seasonal — It’s Foundational

Think of therapy like tending a garden. You don’t just water it when it’s wilting — you care for it consistently to see it bloom. Our mental health is similar. Sunny days don’t always mean we’re done healing. Sometimes they offer the best light to see things clearly.

Final Thought

Enjoy the sunshine, take the beach days — but don’t lose sight of the steady work you’ve been doing in therapy. Emotional health isn’t a seasonal project. It’s a lifelong investment in yourself.

Telepsychiatry in Maine — Serving Portland, Bangor, and Southern Maine

Psychiatric Care Across Maine — From Anywhere You Are

Whether you live in Portland, Bangor, Lewiston, or a small town in between, accessing personalized psychiatric care can be challenging. Long waitlists, long drives, and a shortage of providers often get in the way of people getting the support they need.

As a board-certified psychiatrist practicing exclusively via telehealth, I provide accessible, compassionate psychiatric care across the entire state of Maine. All sessions are conducted securely and privately via video, from the comfort of your home.

I work with adults facing a range of concerns, including:

    • Depression and anxiety

    • Trauma and stress-related disorders

    • Midlife transitions

    • Sleep difficulties

    • Medication management and psychotherapy combined

Why choose telepsychiatry in Maine?

Same high level of care you’d receive in person

No commute or wait times

Flexible scheduling

Available statewide — from Aroostook County to York

About Me:

Serving Patients in Bangor and Throughout Maine

Although my practice is fully virtual, I work with many patients in the Bangor area — as well as those in surrounding towns like Brewer, Orono, Old Town, and Hermon. Whether you’re a student at UMaine, a professional balancing a busy schedule, or someone living outside the city with limited access to care, telepsychiatry makes it easy to receive high-quality, private psychiatric care without the need to travel.

I also provide psychiatric care to residents across Maine — including Portland, Augusta, Lewiston, and rural communities that often lack local psychiatric resources.

Whether you’re in a rural area with limited access or just prefer the convenience of remote care, I’m here to help.

If you’re looking for a psychiatrist in Maine who offers both medication and therapy and truly listens, I invite you to learn more or contact me through my website:
👉 www.drmadelinegoodman.com

Madeline Goodman, D.O., Diplomate, American Board of Psychiatry and Neurology
Psychiatrist for Adults – Licensed in Maine
100% Telepsychiatry | Accepting New Patients

Telepsychiatry in Maine — Serving Portland, Bangor, and Southern Maine

Psychiatric Care Across Maine — From Anywhere You Are

Whether you live in Portland, Bangor, Lewiston, or a small town in between, accessing personalized psychiatric care can be challenging. Long waitlists, long drives, and a shortage of providers often get in the way of people getting the support they need.

As a board-certified psychiatrist practicing exclusively via telehealth, I provide accessible, compassionate psychiatric care across the entire state of Maine. All sessions are conducted securely and privately via video, from the comfort of your home.

I work with adults facing a range of concerns, including:

  • Depression and anxiety
  • Trauma and stress-related disorders
  • Midlife transitions
  • Sleep difficulties
  • Medication management and psychotherapy combined

Why choose telepsychiatry in Maine?

Same high level of care you’d receive in person

No commute or wait times

Flexible scheduling

Available statewide — from Aroostook County to York

About Me:

Serving Patients in Bangor and Throughout Maine

Although my practice is fully virtual, I work with many patients in the Bangor area — as well as those in surrounding towns like Brewer, Orono, Old Town, and Hermon. Whether you’re a student at UMaine, a professional balancing a busy schedule, or someone living outside the city with limited access to care, telepsychiatry makes it easy to receive high-quality, private psychiatric care without the need to travel.

I also provide psychiatric care to residents across Maine — including Portland, Augusta, Lewiston, and rural communities that often lack local psychiatric resources.

Whether you’re in a rural area with limited access or just prefer the convenience of remote care, I’m here to help.

If you’re looking for a psychiatrist in Maine who offers both medication and therapy and truly listens, I invite you to learn more or contact me through my website:
👉 www.madelinegoodman.com

Madeline Goodman, D.O., Diplomate, American Board of Psychiatry and Neurology
Psychiatrist for Adults – Licensed in Maine
100% Telepsychiatry | Accepting New Patients
www.madelinegoodman.com