A Therapist’s Honest Take: What Weight Loss Drugs Really Do to Your Mind

Aisha, 31, works in Mumbai's advertising world. She calls herself "the queen of the late-night snack raid"—chips, biscuits, and sometimes cold paratha straight from the fridge. She jokes about it, but in therapy, she tells me what really hurts: "I feel possessed by my hunger. It's louder than me."

She consulted countless nutritionists and diabetologists to get her diet in order, but it always started the same way: a disciplined few weeks, maybe three months at most, before she resorted to Swiggy-ing her late-night munchies or ordering that extra dessert on tough work days.

When Mounjaro (tirzepatide), the weight-loss injection, became available in India this year, she noticed colleagues swapping stories: tighter clothes loosening, appetites dimming, restaurant bills shrinking. She wasn't immune to the appeal. For her, it sounded like salvation—a quieter mind, not just a smaller body.

And she was right, partly. Within weeks, food wasn't screaming at her anymore. But something else got louder.

Why It Feels Like Relief

GLP-1 drugs like Mounjaro mimic a gut hormone that slows digestion and communicates directly with the brain's hunger pathways. People often describe the effect not as willpower, but as silence—cravings no longer running the show. That can feel deeply empowering.

Being in control of what you eat and when you eat can be profoundly stabilizing, especially after years of mindless emotional eating. Studies show that weight loss linked to GLP-1s or bariatric surgery can ease depressive symptoms, partly by improving sleep and reducing pain. Tirzepatide is even FDA-approved for treating sleep apnea in higher-weight adults—a condition that often fuels fatigue and low mood. In India, where social stigma around weight is relentlessly harsh, simply feeling more in control of appetite can reduce daily shame.

Whether or not to use these drugs is complex. But here's the thing: mindless eating creates a vicious cycle. It fuels depression, an unhealthy self-perception, and more mindless eating. While therapy alone would be ideal, the reality is more challenging. The mental chatter is like whispers—clients often don't realize they're reaching for the next KitKat until they've finished the tenth from the box. The self-hatred that follows is damaging.

Drugs like Mounjaro quiet the food noise. They silence the chatter and prevent that automatic reach for another KitKat. They also create natural consequences when you do overeat—nausea follows, just like when someone with alcohol addiction takes medication and experiences violent vomiting when they drink.

Here's what I find interesting: there's no moral judgment when someone with alcoholism takes medication to stop drinking. There's praise and support for making the right decision. But why do people still view drugs like Ozempic and Mounjaro with moral questioning? The food noise is addictive. If willpower alone were enough, things would be very different.

"When food stops being the loudest voice in the room, the rest of your life can finally speak."

Why It Can Backfire

But research reveals another story. Weight stigma itself—being judged, ridiculed, or self-shamed—correlates strongly with depression and disordered eating. Weight cycling (losing, regaining, repeating) worsens this effect. Too often, people like Aisha have tried healthy diets and fad diets, but lifestyle and work demands don't support long-term change. The physical and emotional toll of work and personal life makes it difficult to exercise the willpower needed to stick with it. It's easy to say "change your job," but the job pays the bills. Sometimes, it's about survival.

Aisha started working at 18. She was the eldest of two sisters, with a homemaker mother and a father who was, rare as it sounds, a non-corrupt government official. His modest salary barely covered necessities. Most of their childhood was spent in their cousins' hand-me-downs, while their father took loans to pay for their education.

For Aisha, working wasn't a choice—it was survival. If she didn't earn, the family's debt would only deepen. Yet at 18, survival meant more than just paying bills. Friends, coffee outings, the occasional movie ticket, even that extra samosa outside college—all of it mattered. Having her own money meant she could belong.

She hustled through college and by 21 had landed a job. She worked tirelessly—first to clear her father's loans, then to buy her parents a modest home in a tier-2 city, and eventually to support their life with dignity. Over time, her sister contributed too, but the early years had already set the pattern.

Food had become her comfort tool. In moments of stress, she ate mindlessly, almost automatically. At 26, standing 5'6", she weighed 130 kilos. She tried diets and exercise plans and did lose weight—sometimes dramatically. But the discipline never lasted more than a few months. The lifestyle that had shaped her for years pulled her back. Conditioning built over a decade of stress-eating couldn't be undone with short bursts of "healthy living."

Here's where it gets complicated. Some data suggests a small subset of Mounjaro users experience worsened mood, anxiety, or even suicidal thoughts. The science is still unsettled, but the risk is real enough that if you have a history of depression, your doctor and therapist should monitor you closely.

In therapy, Aisha found that her quieter appetite freed up mental space—but it wasn't all peaceful. Memories surfaced, the ones she had buried. That night she couldn't attend her best friend's party because she had no clothes to wear or money for a gift. The birthdays she kept quiet about, knowing friends would expect a treat she couldn't afford. The countless moments she made herself invisible, because being seen meant risking the shame of her family's finances.

Aisha's story, like everyone's, has layers. Her mindless eating was never just about food—it was about money, responsibility, care, and the endless need to prove she was enough. I share these layers because no one chooses to lose themselves. It happens when circumstances and relationships close in, and we reach for whatever helps us cope.

Without hunger as a distraction, Aisha finally had to face the story she had buried: "I thought having more money would make me feel enough."

"Weight loss can shrink your body—and expand the silence where old pain lives."

A Therapist's Tool for the Middle Ground

Here's a simple ritual I often give clients on Monjaro or any structured weight-loss plan:

This is why we designed our Sunday Journaling Series: a slow, guided way to stay emotionally attuned while life (and body) changes.

What Changes When You Try This?

Aisha kept her Mounjaro plan, but she also kept her Two-Note Journal. Three months in, she noticed a pattern: her sleep was better, her workdays smoother, but her mood dipped sharply whenever relatives commented on her weight. Naming that pattern gave her power. She discussed it with her therapist, and together they worked on setting boundaries around body talk.

She didn't stop losing weight—but she stopped losing herself in the process.

References

• FDA approval of tirzepatide for sleep apnea: FDA, 2024
• Bariatric surgery & mood outcomes: PubMed Meta-analysis, 2021
• Weight stigma & mental health: APA, 2020
• Psychiatric side effects of GLP-1s: Nature Medicine, 2023