I had a little chit chat with my psychiatrist today. He always opens the conversation with “How are things going?” I was able to say “pretty good, stress at work, but that’s the usual.” He dove right into the secure message I sent him about not wanting to take naltrexone to help me control my drinking habits.

He let me know the benefits of it, and that I had expressed having some trouble controlling my alcohol intake, and it could be very helpful. I mentioned that my therapist and I had talked about HARM reduction, and I explained what my goals were and how well I was doing achieving them without medication. He let me know that naltrexone is a type of HARM reduction, and for me to know it is available as an option should I need it.

Then I just blurted out what was in my heart, what had cluttered it up with silence. “I thought you would be mad at me.” He laughed. “No, I’m not mad at you, I just thought you might like to use it to control your drinking. If you want to try it without, that is certainly a decision you are free to make.” I don’t know what kind of crazy it is to worry about angering your psychiatrist, some kind of unresolved daddy issues or feelings of inadequacy, but there you have it folks.

Here comes the funny and sad. He switches the conversation to “I wish you could go back to your primary care doctor and be more insistent that you find a way to have insurance cover you for Wegovy or Ozempic.” These are weight loss drugs that are prescribed to patients with diabetes; they are expensive and my primary care doctor says insurance will only cover them if you are obese and I am just overweight. But my primary point here is that my psychiatrist appointments are online, and I use my cell phone to converse with my doctor. So he must have noticed that my face is getting fatter due to the weight I have gained and that was his less than subtle way of saying so! He could have just said, “Gee, you face looks fatter, how much weight have you gained?” I just fessed up to spare him, told him my number and that I am the heaviest I have been. He could have just said it’s time to take those fat face pills and I would have told him I will get right on that.

So that was my April visit with my psychiatrist. There’s almost always something funny that transpires, and for that I consider myself blessed. Because I remember the darkness and hopelessness that used to permeate those appointments. But really, it’s not funny that my medication made me gain weight. It works like a charm, and that is just one of the side effects. I do need to get serious about losing weight, so if I start to sound really grumpy, you’ll know it’s because I’m changing some bad eating habits.