Ozempic: Questions from a Therapist

I'm not a medical doctor or nutritionist, so I can only pose questions. These are based on my observations from clients, family, friends, and stories I've heard/read in the media. I know that not everyone is impacted the same way and results/side effects vary according to how much is used and other individual variables. My goal isn't to judge or sway - I have no way of knowing if ozempic would be good or bad for you-, it is simply to bring more nuance, information, and conversation to the topic, so that people can make a decision with true informed consent. I won't discuss the medical side effects and will instead stay in my lane of mental and emotional health.

- From a psychology perspective, will the lack of muscle (strength) impact your daily life, long-term goals, values? (Ex: Being an active parent, grandparent) You can workout to gain muscle, but how successful will that be when functioning at a calorie and nutrient deficit? Knowing that building muscle gets increasingly difficult with age, how does the significant muscle loss during ozempic use impact overall health? How will it impact quality of life? What effects does lack of muscle have on bones, joints, ligaments, skin, and organs over time?

- Ozempic partially works by decreasing the derived pleasure from eating (and drug use), so with this innately comes a decrease in ALL pleasure, resulting in a generalized anhedonia. How will this impact your overall quality of life? How can you combat the general anhedonia (lack of interest in all things that bring you pleasure)? Sure you can force yourself to engage in things that bring you joy, but will you be fully present? As a therapist, my wishes are that everyone can be fully present in every moment, finding joy as often as possible. In the mundane, the good, and the bad.

- Starving yourself puts your nervous system into a prolonged/perpetual fight, flight, freeze state. Leaving you on a short fuse, quick to anger, burn-out, etc. Also decreases cognitive functioning. What are the day-to-day repurcutions of this on your relationships? How can you manage the "hangry"? Would eating high quality healthy fats help? If that puts you in extended ketosis, what is the impact of that on your hormones, organs.

- Which facets of your life will taking ozempic improve? Notice if your answers stem from one main category (physical appearance) or if they span the board and encompass: emotions & mental health; physical health; relationships; vocation; finances. For some, it is likely that losing weight will allow them to have more confidence (improve mental health), participate more freely in certain activities, and improve their physical health. But be real with yourself about if all of that just stems from 'looking better', having a specific physical appearance, or if it is deeper. ( If the answer to how will this improve my __(relationships)__ always starts with ‘well if I look better I'll ___' that might be a sign.

- How will you know when to stop? Like all good things, there is a point at which it goes too far. Do you trust yourself to know where that line is? Is there a risk of developing an eating disorder and/or body dysmorphia?

Again, I don't know your specific situation, I don't have a dog in the fight. I just wanted to highlight some of the gaps I see in the conversation and add more to the decision tree. My hope is that each person has enough information to make truly informed, confident choices. And this admittedly is not a conclusive list but I hope that it at least opens some doors for more thorough exploration.

Task management tips

In session the other day I was helping a client with some task management. She was feeling pretty overwhelmed with a never-ending to-do list and getting bogged down with a lot of “should”s. As I’m sure most of you can relate to (I certainly can), this can trigger a shame spiral that often ends in us avoiding any of the tasks on our list.

We were exploring the usual ADHD-esque tips for prioritizing tasks, yadda yadda, and it occurred to me that knowing which tasks are the priority isn’t the issue here. The emotions behind the tasks are what’s blocking her. So instead of ranking the tasks by priority, I suggested she scale each task according to it’s emotional weight: 0-5 with 0 being the least emotional and 5 being the most. Then she can easily see which tasks are weighing on her emotionally, which gives her more information on when she can best tackle it and who she can ask to help.

This not only adds a layer self-awareness that can be super helpful, it also disrupts any authority defiance patterns that may be happening. The clarity she received through this spurred self-compassion and relieved a little pressure so that she was able to get new ideas on how to break the task into smaller steps and who in her support network would be best suited to assist with any aspects. Knowing if you need moral support, help lifting and moving stuff, a discerning eye, an unbiased third party, outsourcing, etc. can go so far in getting you the right help.

What are some tasks that have been looming on your list? Do you think this approach might help you get some clarity on why you’re avoiding them? Can implementing it help you get the right support with those tasks? I’d love to hear from you!

The beginning

Hi hi! Welcome! To you and to me. I don’t really know if I want to do this, but here we go. I’m a shy therapist, getting over a fear of being seen. The thought of my ideas, of me, being publicly visible is nerve wracking. The internet seems ripe with the unwell. Something about having a barrier to hide behind tends to embolden the bullies. But having a place to drop bite size musings that keep tumbling around in my head keeps calling to me and I’m all about listening to my intuition, to the Universe. So here it is: MUSINGS. A place where I release often half thought out content. Partially to engage in conversation, to get more wheels turning, and partially to just put it out there, let you think about it and come to your own ideas. Or not. This isn’t about my way being right or even coming to any sort of conclusions like that. It’s about shining a tiny light on topics that might not be spoken out loud. Sometimes it might be tips, sometimes questions, sometimes venting. We’ll see. Perhaps a less personal LiveJournal {I was recently emailed about my 20th(!!) LiveJournal birthday, an account I didn’t even know still existed, much less how to log in to it. A very special shoutout to anyone who gets the reference}.

Thanks for being here. Feel free to stick around if things continue to resonate and peace out when they don’t.

With love & courage,

A