Category: Maine Psychiatry

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.

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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.

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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.

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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.

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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.

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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