Fucked up relation with food and binge eating + no motivation/depressed mood. Need to fix this long term.

[Luke391]

Before I keep getting called Mr dismorphia and people keep pulling up those 2pics of mine where I was lean, I'm not that lean anymore, so that is not the issue.
I acknowledge I got some mental issue anyway.

Rn I'm 20yrs, 5'6 about 145lbs-ish. skinny fat because I burned out due to stress and stopped training completely about 2months ago.
In those 2pics I had posted I was about 132-133lbs.
Before GLPs I was about 180lbs with no muscle.

I am on high dose GLPs, 10mg Tirz + 2mg Cagri (Cagri did absolutely nothing so I will stop it next week). I started because I wanted to get my binge eating under control, I had severe binge eating since I was like 13-14 and always went up and down in weight a lot (like 50+lbs up and down, mostly up).

I went to tons of therapists and phychiatrists over the years but it never really helped. for me it's just because I think about food 24/7 and always want more, like I'm never satisfied.
This whole thing started after I lost weight for the first time when I was like 13 (grew up fat).

When I started Tirz in february it completely fixed the binge eating for a couple months, then it came back, upped the dose and same issue happened. now I am at a point that I always wanna binge or hyper-palatable crap and if I don't I can't do anything else, or even rest because I'm so restless due to the cravings. Even after eating perfectly strict for months I'd have relentless food cravings for junk.

Also what happened when I had started dieting at 13-14 was that I completely lost enjoyment and passion for anything else. I still can't get myself to care about anything else anymore. videogames are boring, painting is a pain in the ass and even socializing is just tiresome.
Working or building a career also just feels dull and pointless.
Since then I've never been able to have any passions or drive to do any anything other than out doing it out of guilt/sense of duty, so food feels like my only source of enjoyment.

I was put on anti-depressants twice when I was 14-15 but they only made things worse at the time.

I'm also exhausted never have any motivation, rn I stopped training because it was either I keep training and don't have the energy to go to work or viceversa. I'm taking SLU-PP-332 at 5mg daily because I don't think I'd be able keep going to work without it.

So basically I'm stuck in a cycle of finding short term "fixes" to get me to loose fat and train consistantly for about a year at a time, then to fall back into binge eating and this sort of chronic exhaustion.
I can never really find something that is sustainable without struggling 24/7 to keep a diet or maintaining training.
These cycles also comprised school (when I was still in school), when I was dieting and training I would be doing very well, then when I burned out I'd completely drop out and barely scrabe by thanks to the good grades I had gotten previously, and now this continues with my job. I wanted to go to University but because I can't find passion for anything I know I won't make it trough 3-5years of actual studying.

I tried therapy again this past month but it seems useless, I'm just talking to some guy who tells me nothing, and any sort of "realization" I might make is no use to me.

Food is basically my main issue because it's all I think of all day long, to the point I can't focus or do anything else. So I'm not sure what to try next, some therapists told me I have OCD and others told me I am depressed but idk at this point.

Any idea on where to even start to fix this mess?

 

[Doodle]

You need to keep looking for a good psych and therapist. I went through several. Then one day I met my current doctor and he really helped me. He listened to all my research and allowed me to try new things. Antidepressants are plenty. You have to experiment. Some people react to SSRIs. Some respond to NDRIs. Some like atypical antidepressants. After many med changes I finally found one that worked. I also take adderall which helps limit binging. Both Wellbutrin and Adderall changed my life. Vyvanse is similar to Adderall. It’s extended release and is used to treat binge eating. I would research some more and keep searching for a good doctor.

Edit to add: antidepressants can take around 6-8 weeks to feel the effects. You have to be patient.

 

[IndividualMan]

Go through more doctors, and any way to incorporate NDRIs at dosages useful to your goals might be the way to go.

Tesofensine could be useful, but I would try finding a good antidepressant to go with it, and up dosages VERY SLOWLY.
Fluvoxamine+Tesofensine, for example.
Be weary of serotonin syndrome tho. its nasty and can fry you long term.
Or Adderal/Vyvanse/whatever ADHD med which helps limit binging, + whatever antidepressant goes with it.

If you are a real substance fiend, you could do Intranasal Semax as well once you got your meds figured out, so you can follow your college dreams a little better. But thats just a treat for when you are on track to living the life you want to live.

Good luck to you, I hope you find the Meds you need, and a psych who prescribes them to you.

 

[Ghoul]

This is rare, but precisely the kind of disorder people suffer from for decades, often making several stops at “it’s in your head see a psychiatrist”, before stumbling across someone who can diagnose and (in a life altering way) treat it:

Have you ever been evaluated by an endocrinologist for Leptin pathway dysfunction? This is exactly the kind of disease that causes unrelenting appetite from childhood,, and in my opinion, more likely than anything psychological that could induce symptoms strong enough to overpower any GLP dose.

It’s completely treatable now with recombinant Leptin that can be used as a replacement for insufficient production of that hormone. Sometimes there’s enough but you have a gene that makes you insensitive.

Almost no other type of doctor is going to be familiar with this, even endocrinologists don’t encounter it often, but it’s very real and they know how to diagnose it (and other related conditions, even a benign brain tumor can cause symptoms like you’re describing).