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

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.

How AI Is Changing Psychiatry – And What It Can’t Replace

By Dr. Madeline Goodman, Psychiatrist & Psychotherapist

In the past few years, artificial intelligence (AI) has moved from a buzzword to a powerful presence in healthcare—and psychiatry is no exception. From chatbots offering mental health support to algorithms screening for depression, AI tools are being hailed as the future. But as someone who practices both psychiatry and psychotherapy, I see both the potential and the limits of AI in mental health care.

What AI Can Do in Psychiatry

AI can be remarkably helpful in specific ways:

  • Screening and early detection: Algorithms can flag symptoms of anxiety, depression, or even psychosis by analyzing speech patterns, facial expressions, or written language.
  • Support tools: Chatbots and apps like Woebot offer basic cognitive behavioral techniques, which some people find helpful between therapy sessions.
  • Administrative support: AI can assist clinicians by summarizing notes, organizing data, and predicting medication responses—reducing our time spent on paperwork.
  • Access expansion: In underserved areas, AI-powered platforms can provide some mental health support where human clinicians are scarce.

These are all meaningful contributions, especially in a system where access and time are limited. But psychiatry is more than pattern recognition.

What AI Can’t Replace

While AI might be efficient, it lacks emotional depth. Psychiatry is not just about diagnosing and prescribing—it’s about understanding the human story:

  • The therapeutic relationship: Healing often happens in the relationship itself—through being seen, heard, and understood by another person. This is something no algorithm can replicate.
  • Complex emotions and nuance: Human distress is rarely neat. A person may present with anxiety that is also grief, that is also trauma, that is also existential. Understanding that layering takes attunement, not coding.
  • Unconscious processes: As someone trained in psychodynamic therapy and dream work, I believe that unconscious patterns shape behavior in ways AI can’t access. Therapy often means sitting with uncertainty and ambiguity—territory machines aren’t built for.

How I Use (and Don’t Use) Technology in My Practice

I value useful tools. I offer telehealth, I keep up with emerging technologies, and I understand the appeal of convenience. But I’ve also seen what’s lost when care becomes too transactional.

My practice offers something different: personalized, attentive, and deeply human care. Whether you’re navigating midlife transitions, relationship changes, or long-standing patterns, I create a space for exploration that goes beyond symptoms.

The Future: Human + AI, Not Human vs. AI

I’m not anti-AI—I think it has a role. But I believe the future of psychiatry is not about replacing clinicians. It’s about supporting them, so we can focus on what machines can’t do: build relationships, tolerate uncertainty, and sit with pain compassionately.

If you’re looking for mental health care that combines depth, professionalism, and a human touch, you’re in the right place.