Dr. Rachel Goldman

I do, all the time, unfortunately. Right. It's completely normal, you know, to be experiencing all of those different emotions because there's so much going on, right? So if we think about taking the medication, losing this amount of weight, it doesn't just end there, right, as Anya has been talking about.

But there's so many changes going on and emotional changes that people don't really anticipate or expect, unfortunately. Mm-hmm. And I like to explain it in a way that there's a lot of changes that people don't expect. And they end up saying like, oh, that's not going to happen to me. And they don't really understand until it does happen to them.

And there's so much because individuals are learning to navigate life in a different body.

and and that's difficult for many reasons any change can be really overwhelming a good change or a bad change right it can be overwhelming and a lot of emotions and then when like what michaela just expressed you know people are treating her differently people are you know or what brian said before that people are opening the door for him and being kinder

There's that realization of like, wow, the world in our society is really viewing appearance as, you know, putting so much weight on that appearance.

Yes. And I actually was just going to say that every relationship serves a purpose, right? Yes. Every single one. And at the time when Mikayla was in a larger body, the relationship that she had with those friends and that dynamic was very different. And now the dynamic is changing, which is, again, unfortunate because she's still Mikayla. Mm-hmm.

But I am going to add, though, she now has this newfound self-confidence. She has this newfound self-esteem. She feels better about herself. And that shows. And everybody around her that isn't, so to say, like catching up so quickly isn't familiar to that. Right. That's not comfortable. This isn't the Michaela we know. Yes, exactly. Because we like what's familiar.

We like what's comfortable as humans. So in a way, we're like shaking that dynamic up. We're changing things. And that can be scary to other people, which is unfortunate for us or for Michaela, because again, she's still Michaela.

Absolutely. And it's important to remember that we can have conflicting feelings and emotions at the same time, right? So we can be feeling happy about aspects of this. I got my life back. I'm happier and all of these things. And we can be angry and upset and sad at about the other aspect, like the relationships and people treating us differently in the way that the society is.

So it's completely normal. And I think it's important that people remind themselves of that. We can have conflicting emotions and feelings at the same time. We're human. There's a wide range of emotions that we all have, and we're never just one single emotion.

Yes. So great question. And obesity is related to so much. As Dr. Anya had mentioned before, it's multifactorial. It involves so many different illnesses and diseases. And we all have mental health, and actually everything impacts our mental health.

And if we think of just obesity for a moment, we're talking about not just weight, as we've been saying, but we're talking about the emotional aspect, the emotional piece even related to food and eating. We're talking about body image, self-esteem, self-confidence, self-worth. All of that is being impacted by, again, our weight, our appearance, but also the disease of obesity.

So everything is tied to our mental health and that's going to impact how we act. It's going to impact the way that we think and how we think about ourselves, the words that we use when we talk to ourselves, and that impacts our emotions as well. So it's absolutely all related.

And I really thank you for that question because mental health is so important and we can't be having this conversation without talking about mental health.

Yes, absolutely. A lot of people come to me saying, you know, I have one client in particular that's like, oh my gosh, I'm flirting. Like people are flirting with me and I've never experienced this, right? So there's that also that there's a lot of newness to this. And people are, again, like we said before, are going to treat you differently, unfortunately, but it's how we learn to navigate that.

And that's where the emotional piece comes in because this is different. It's something that you're not used to. It's something that could have caught you off guard, which is why what Dr. Anya said before, I want to just highlight that, for instance, with bariatric surgery, most bariatric surgery programs require individuals to see a mental health provider like myself before having surgery.

And we talk about the changes to expect after surgery. Unfortunately, with these medications, that is not the standard. And I really wish it was. I do have a few clients that have come to me saying, I want to start these medications. I know there's going to be changes and I want to talk about it and get ahead of it, which is amazing.

Unfortunately, mental health services, just like certain health care, is not accessible to everybody.

Yes. So I think, you know, I just want to add the piece that there's a lot of changes that are going to happen. So if somebody decides to go on an anti-obesity medication, it's not just about doing an injection once a week. There's a lot that's going to happen. And I think it's important that people acknowledge that, that there's amazing changes that are going to happen.

There's going to be a roller coaster of emotions. There's going to be changes that you didn't expect and changes that you maybe heard from other people and didn't think would happen to you. And the most important thing that you can do is to find not just the right doctors, but define a supportive community.

And I understand that not everybody can have a mental health provider in their back pocket or afford therapy, but having that supportive community Figuring out who your go-to people are, who can lift you up, who can help you navigate this. If that's, you know, parents like some of the moms that have been here or other people.

Right. Because there's going to be comments. Unfortunately, there's going to be different emotions, different comments about food and body shape, size. And people need to know how to be prepared for that.

Yeah, I'm so glad you said that because similar to what Dr. Anya said before, if somebody was like, oh, what are you doing for blood pressure? Somebody would say, oh, I'm not eating as many salty foods and I'm taking medicine. Right. So I think that just feeds into the whole idea that we're trying to. change the way that we're thinking about this because obesity is a disease.

So if you own it, that would be amazing because then we're helping other people understand.

Yeah. And all of the psychosocial things that we're seeing now with the medications, we've been seeing for years with bariatric surgery, the relationship changes, the body dysmorphia, all of that we've known about. I mean, I've been talking about it for years to my bariatric surgery patients, but now it's becoming something new because it's now with the medications as well, but it's not new to us.

And that's why we need to be having these conversations. Well, thank you for being a part of this one. Thank you. Thank you so much for having me.