Twelve things I’d tell someone picking up their first prescription

Dear You,

If you’re reading this in a pharmacy parking lot with a paper bag on the passenger seat, hello. I was you, about three years ago. Here’s what I’d lean in through the window and tell you, one person’s list, in no particular order of importance.

1. The silence will be the first thing you notice. Somewhere in the first week or two, the constant background hum of thinking about food will go quiet. It’s eerie. You’ll check for it like a tooth that’s stopped aching. Let yourself be weirded out. It’s a lot.

1. Week six is hard for a lot of people, and nobody warns you. Something about the novelty wearing off while the side effects haven’t. I’m not going to tell you it’s easy. I’ll tell you it passed, and that having a plan for a boring week helped more than pep talks.

1. Side effects, dosing, and anything in the “is this normal” category go to your care team, not to a forum, not to me. Save their number in your phone under a name you’ll see. I called mine twice in the first month and both calls were worth it.

1. You will need to re-learn cooking. Recipes assume an appetite you no longer have. A pot of chili for six becomes a fortnight of chili. Start cooking for one, in small dishes, and freeze in portions the size of a fist.

1. Start a paperwork folder today. Prior auths, receipts, pharmacy messages, the denial letter you hope never comes. Digital or physical, doesn’t matter. Future you, on hold with the insurer, will be grateful.

1. Protein goes first on the plate. When you only get a few bites before “full” shuts the door, make the first bites count. Everything else is garnish.

1. People will have opinions. Some will be thrilled for you. Some will be weird about it. Some will be weird about it because they want to ask for themselves and don’t know how. You don’t owe anyone an explanation, and you can change your mind about who knows.

1. Buy small bowls before you buy small clothes. The clothes will come when they come. The bowls change tonight’s dinner.

1. Alcohol will hit differently, and restaurants will become a planning exercise. Neither is a tragedy. Order the appetizer as your main, share dessert, and ask for a box without apologizing.

1. Keep moving, especially the kind of movement that picks things up. Eating less means your body goes looking for fuel, and you want it to leave your muscle alone. That’s a care-team conversation too, but it’s one worth starting early.

1. The prescription came with instructions. Life was apparently sold separately. The medication quiets the appetite. It does not tell you who you are when food isn’t the organizing principle of your day, how to sit through a party with a full glass of water, or what to do with the three hours a week you used to spend thinking about lunch. You figure that out. Slowly. With help, if you want it.

1. Nobody tells you about the maintenance part. The day will come when the losing part is over and the attention fades and you’re left with an ordinary life in a different body, and that’s where the real work is. I wrote a whole guide about it, After the Noise Stops, because I went looking for one and couldn’t find it. But for today, you don’t need it. Today you just need to go home, read the pamphlet, put the box where it belongs, and eat something small.

A last thought from the window before I let you drive off. There’s a phrase I come back to on the odd days: Some days you’ll finish the bowl. Some days three bites is dinner. Both count. Write it on the fridge if you need to. I did.

Want to tell me something? Reply to any Low Volume email, or write to me here. I read everything.

Getting Quiet shares lived experience, general education, and practical tools. For medical decisions and individual treatment questions, talk with your qualified care team.