GLP-1 Time? Need Guidance

If both your clinician and doctor are aligned on GLP-1 as the recommendation, that's actually a strong position to start from - having the medical team on board means you're not navigating the justification argument while also managing side effects. The nearly obese classification with clinical backing is exactly the profile these medications were designed for.

The calculation question is a good one and you're right that the remaining-to-goal number is more useful than the from-start percentage when trying to assess rate and timeline. The OP with 130 to lose is earlier in the journey - the calculation matters most when the pace starts to feel slow relative to where it started.

300+ since '09 and hitting 390 in '22 with the depression and bipolar in the mix is a picture where medication resistance and weight gain reinforce each other. The GLP-1 effect on mood in some people is a real secondary benefit that shows up in threads like this. Getting started at any point is the right move - the 'I should have done this sooner' feeling is near-universal once it works.

Please talk to your medical team about this as soon as you can. They might end up supporting the idea of you starting a GLP-1 down the line, but what you're currently doing sounds genuinely unhealthy.

Sounds like maybe you're just not ready yet. There'll always be some reason to put it off. I actually kicked mine off right around the holiday break last year, timed on purpose so I wouldn't repeat the usual overeating stretch.

Any telehealth options or a dedicated weight clinic near you? Might be worth getting another perspective at this point!

Reading your post, sounds like chronic obesity or at least chronic overweight status describes you well. Medical treatment for a chronic condition isn't failure. Even calling it that, so what? You've already said something needs to change.

You mentioned trying everything, but the piece that's stayed out of reach is a lasting lifestyle shift. Sure, other factors matter, but sustainable loss generally needs a real deficit plus activity. For chronically overweight people though, that's rarely simple.

A GLP1 isn't magic. It's a tool for rebalancing appetite hormones and getting insulin resistance under control. Plenty of people carrying obesity have genuinely abnormal hunger biology, elevated leptin and leptin resistance being common examples. Maintaining a deficit while leptin's abnormally high is basically fighting upstream constantly. Body and brain both insist more fuel is needed than actually is.

Seeking a physician who pairs treatment with nutrition support is worth it.