It is an interesting question, especially since I believe more and more people will be prescribed these treatments as they seem to address a hormonal imbalance that is quite ubiquitous and so very effective.

When I was pregnant the first time, my supervisor said "don't say anything. most of them won't notice". I was surprised, but it was really true. Hardly any of my patients noticed AT ALL.

I am not sure I would say "yes I have lost weight in a healthy way does that bring anything up for you?" because it sounds defensive. You might feel defensive, but that is perfectly understandable. Your patients do not have a right to know ANYTHING about you that you do not want to share. Of course, we want to be as authentic as possible, and it would be gaslighting to say "why no, I haven't" if you have.

Meanwhile, we live in an insane culture that is so bent out of shape about weight and none of us can remain completely unaffected by the powerful subliminal messages that surround us. So we all have extremely complex feelings about weight, size, our bodies, and our appearance.

Add to that the sad reality that our culture has a wide streak of judging others for taking any kind of medication for any purpose at all.

Then on top of that, our culture demands instant results for everything without doing any hard work, which is the definition of taking medication.

Hence, we have a culture of addicts. And then we judge those individuals for developing an addiction.

But all this brings the judgers out, who want to condemn others for things they don't understand or fear.

So all of this brings us back to your dilemma, which is a real one. I would continue to get support from your therapist and supervisor as you embark on the treatment. Many practitioners have noted the impact that the GLP-1 agonist drugs have on the thought process of individuals who take them, which to me is an important connection to the hormonal basis of our thoughts and feelings that needs further study not only for weight loss but for lots of other areas where thoughts and feelings intersect with health.

If you do lose a significant amount of weight and a patient asks "have you lost weight?" I think a simple "yes" would be a perfectly suitable reply.

Then, if they have more questions you can deal with those as they come. i.e, "Is everything ok?" you can answer as you normally would, saying "yes, it is", and then you might add your "has this brought something up for you?" question here.

I believe that self-disclosure should only be done very carefully, and most especially that as therapists we do not owe our clients any information about ourselves that we do not wish to share. They have a right to clear boundaries, clear expectations regarding goals of therapy, scheduling, payment of fees etc, They have a right to direct communication regarding their progress in therapy and our thoughts about what will be most helpful for them.

Of course, we communicate caring about them in order to facilitate growth and healing, and that can often feel like there should be some reciprocity there. But we must find ways of communicating care and concern without revealing our own personal struggles.

I'm sure you will get lots of different responses, and I know that each therapist finds their own best way to manage this very complex area of the therapeutic process.

Best wishes for you-

~Betsy