
Weight loss today is not just about eating less or taking a medication. Many people using GLP-1 weight loss injections struggle with:
- Low energy
- Nausea
- Mood changes
- Confusion about what to eat
- Fear of hunger
In a recent podcast discussion, Dr. Vikas Gupta, a quadruple board-certified psychiatrist and founder of Wellness Psychiatry, explained why weight loss should never be treated as just a physical process. According to him, mental health, nutrition, metabolism, and lifestyle are deeply connected.
Why Weight Loss Is More Than Just Food or Calories
Mental health and physical health are deeply connected.
Your brain does not live separately from your body.
Many people labeled as having “treatment-resistant depression” are actually dealing with:
- Poor sleep
- Blood sugar ups and downs
- Inflammation
- Processed food diets
- Lack of movement
When these areas improve, mood, motivation, and energy often improve too.
What GLP-1 Medications Do (and Don’t Do)
GLP-1 medications:
- Reduce appetite
- Slow digestion
- Reduce food cravings
But they do not teach your body how to eat well.
This is where many people go wrong.
Important rule:
Eat less naturally — not by starving yourself.
How to Eat Properly While on GLP-1 Medications
Many people stop eating enough or eat the wrong foods because hunger signals become weak.
Focus on nourishment, not just calories
Try to include:
- Protein → protects muscles and mood
- Fiber → supports digestion and gut health
- Healthy fats → supports brain and hormones
- Whole foods → keeps energy stable
Helpful tips:
- Eat small, regular meals
- Choose home-style, simple foods
- Avoid greasy and heavily processed foods
- Don’t skip meals just because you’re not hungry
Calories are only a number.
Nutrients are what keep your body and mind working well.
Should You Avoid Carbohydrates?
Many people are told to eat high protein and very low carbs.
This can cause:
- Anxiety
Low mood - Low energy
- Poor digestion
Better approach:
- Do NOT remove carbohydrates completely
- Choose fiber-rich carbs like vegetables, fruits, beans, and whole grains
- Balance is more important than restriction
Extreme diets may give short-term weight loss but harm long-term health.
Lifestyle Habits That Support Natural Appetite Control
Your body already makes GLP-1 naturally.
You can support this by:
- Eating earlier in the day
- Sleeping on time
- Walking daily
- Reducing processed foods
- Eating slowly and mindfully
These habits improve:
- Digestion
- Hormone balance
- Mental clarity
- Appetite control
Alcohol and GLP-1 Medications: What You Should Know
According to Dr. Vikas Gupta, GLP-1 medications slow digestion, which means alcohol stays in the body longer.
Risks include:
- Feeling drunk faster
- Nausea and dizziness
Dehydration - Poor sleep
- Low blood sugar
Safe guidance:
- Avoid alcohol for the first few weeks
- Never drink on an empty stomach
- Drink slowly and hydrate well
- GLP-1 medications lower appetite but do NOT increase alcohol tolerance.
Common Side Effects and How to Manage Them
1. Nausea
- Eat soft foods (soups, lentils, cooked vegetables)
Avoid fried or oily food - Eat slowly
- Don’t rush dose increases
2. Constipation
- Increase fiber
- Drink more water
- Magnesium may help
3. Hair Loss
- Often caused by under-eating
- Make sure you’re eating enough nutrients
Key rule:
Go slow with dose increases. Slow progress is healthier and lasts longer.
Mental Health Changes to Watch For
GLP-1 medications can affect emotions.
Some people may notice:
- Anxiety
- Emotional flatness
- Low motivation
- Body image confusion
- Food guilt or fear of eating
Red flags:
- Eating too little
- Skipping meals regularly
- Using alcohol instead of food
- Feeling depressed after dose changes
Mental health support is just as important as weight loss support.
The Most Important Message
Weight loss alone is NOT the goal.
The real goal is:
- Good energy
- Stable mood
- Healthy digestion
- Sustainable habits
- A positive relationship with food
A smaller body without good health is not success.
🎧 Listen to the full episode: YouTube or visit anew-insight.com under the podcast tab.
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About Dr. Vikas Gupta, want to know more about him here are his social media links:
https://www.psychologytoday.com/us, https://www.instagram.com/psych_today/, https://www.facebook.com/psychologytoday, https://x.com/psychtoday, https://www.linkedin.com/company/psychology-today/
FAQs (Frequently Asked Questions)
1. Is it okay to feel less hungry on GLP-1 medications?
Yes, but you still need to eat regularly to protect your energy, mood, and muscles.
2. Why do I feel nauseous or weak?
This usually happens when you eat too little, eat greasy foods, or increase the dose too fast.
3. Should I lower my dose if side effects are strong?
Yes. Talk to your doctor. A lower dose that feels manageable is often better than pushing through discomfort.
Here is the Transcript:
Supatra solo part ONE: [00:00:00] Hello and welcome. I am so thrilled and very honored to have quadruple board certified psychiatrist and the founder of Wellness Psychiatry, Dr. Vikas Gupta with us today. Oh my gosh, Dr. Vikas, it’s such a pleasure to have you on my podcast.
Vic SOLO part ONE: Thank you so much. Uh, it’s a delayed, uh, Supatra and uh, you can call me Vic. Uh, but, uh, so, so.
Supatra solo part ONE: Okay, wonderful. Vic, I’m gonna read a little bit about my friend Vic, and then we are going to go right into the questions that we have for today. Dr. Vikas Gupta is a quadruple board certified psychiatrist and the founder of Wellness Psychiatry serving patients in New York, California, and multiple other states via telepsychiatry.
His practice specializes in integrative evidence-based psychiatric care across the lifespan with a focus on holistic [00:01:00] wellness, weight management and lifestyle medicine. A nationally recognized leader in psychiatry, Dr. Gupta has served on the faculty of Harvard Medical School and Massachusetts General Hospital, the nation’s top ranked psychiatric hospital.
He currently holds leader, leadership positions within the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry, where he contributes to education, curriculum design, and continuing medical education initiatives. He also collaborates with the FDA network of experts and is a member of the APA Research Council.
Dr. Gupta’s clinical focus includes helping high performing professionals manage stress, burnout, and complex medication regimens, while also offering innovative treatments for obesity and mood disorders. Through his Wellness Psychiatry platform, he blends [00:02:00] psychiatric expertise with whole person wellness to help patients achieve lasting transformation.
Vic, welcome.
Vic SOLO part ONE: Thank you so very much Supatra, so delighted to be here with you
Supatra solo part ONE: Well, thank you so much. You’re, you are honoring me with your presence in this podcast. You have, I, I think, a very prolific and unique career that blends psychiatry, obesity, medicine, and holistic wellness. Tell me what your inspiration was to pursue this path and what continues to drive your mission in your practice.
Vic SOLO part ONE: So I’m a psychiatrist, uh, trained to think in diagnostic codes, but our patients, uh, live in bodies, families, workplaces, and kitchens. So the practice Wellness Psychiatry was born from realizing that mind metabolism and meaning are inseparable. Uh, during residency training, I had seen patients being labeled treatment resistant depression, yet, uh, you know, other factors were [00:03:00] implicated.
Sleep was perhaps complicated or imp. Uh, chaotic meals were some somewhat. Not very healthy, maybe ultra processed and, uh, movement was non-existent. Uh, so when I trained in obesity medicine, um, a light bulb went off. Wooden metabolism, as, you know, constantly talk to each other. Uh, low energy inflammation and glucose, uh, swings, scan, mimic or magnify, uh, mental health, uh, conditions, our psychiatric symptoms.
So I built a model that treats the three layers together. One was the physiology, which is, which includes metabolic health, uh, biology and hormones. Second was, uh, the impact of psychology, including habits, motivation, and other factors like trauma. And third, very importantly, is purpose, which included factors like creativity, connection, and values.
Um, what, what I foresaw was that we align all these three factors. People don’t just lose weight, they regain [00:04:00] agency and vitality. And our mission at Wellness Psychiatry is to make care, make sure that we provide, uh, humane evidence-based and doable care. Uh, less about heroic willpower, but more about building smart systems that can fit real lives
Supatra solo part ONE: I love this. I, I think the main, one of the main reasons other than your amazing reputation that I wanted you to have on this podcast was to talk about how lifestyle medicine, uh, more natural nutritional interventions and things like that have gone the wayside, uh, with the advent of these, um, medications originally designed for, uh, diabetes management, uh, GLP ones and their derivatives.
Um, and I’m seeing a lot of difficulties with, um, you know, disordered eating, eating disorders. Uh, confusion about nutrition, and so that’s why I really wanted to pick your brain [00:05:00] today was to figure out how we can best help people that are struggling. Either before taking these medications, during, after, how can we be providing them with the best care and the most up to date nutritional education, as well as giving them some psychologic, uh, psychological and psychiatric support So.
Let’s start with nutrition. So many people on these GLP one medications really struggle with nutrition. I, I see a lot of confusion, especially just anecdotally online about, uh, you know, macronutrient, uh, proportions about calories. From your integrative psychiatry perspective, how should patients think about nourishment versus just calorie restriction when on these medications?
Vic SOLO part ONE: Such an important question. [00:06:00] Um, so the GLP GLP ones do lower appetite, but they obviously don’t teach nourishment. Um, my mantra is to eat less by default, not by depletion. And obviously when appetite drops, people often eat too little or the wrong things. Um, I recommend focusing on quality over quantity.
Uh, so ensuring there is protein anchor diets, fiber forward diets, minimally processed meals. Um, you’re, as you’re aware, proteins are important to preserving, uh, muscles and maintaining the mood stability, whereas, uh, the fiber intake is important to, uh, for the gut. To support the microbiome as well as to study, study the glucose levels in the body.
Um, also important is the fact that healthy fats are needed to keep the brain and hormones balanced, um, especially for our vegan patients or plant-based patients. Uh, this may look like lentils, uh, ctan [00:07:00] beans, tofu, or colorful produce, uh, which we get plenty in California and several other states. We schedule meals because hunger cues can vanish, uh, after the GLP ones.
And structure, uh, does protect the mental health, meta metabolic health overall. So I do recommend scheduling meals, uh, given the cues can go away. Uh, do set the calories. Uh, I mean, I would say calories do set the budget, but nutrients decide what you can actually build. So nourishment is real important information to the brain.
It shapes our emotions, it shapes our focus as well as our resilience and overall good mental health. Um, so the fact that, um, balanced nutrition, uh, is needed once uh, patients
Supatra solo part ONE: Oh, absolutely. And I see out there an over emphasis on protein as the most important macronutrient that you can consume. Now, I understand that because. These [00:08:00] medications, especially if you are consuming far fewer calories than normal, uh, you will experience first water and muscle loss, especially, most especially if you are on a high protein, low carbohydrate diet.
And that’s what we’ve seen in dieting since, you know, Atkins revolution and, and all of these, you know, Paleo, more animal protein centered, low carbohydrate diets. And so, you know, my, my point to many people is that if that actually worked before GLP’s, we wouldn’t need GLP’s. It really doesn’t work if, if you see a very high, especially animal protein centric diet, it eventually starts to backfire on you.
You may lose some water and you may lose some muscle, uh, in the beginning of the diet, but long-term consumption actually damages, kidney and liver function. Contributes to cardiovascular disease and [00:09:00] contributes, uh, to the, um, to insulin resistance. So how can we help people turn away from that thinking, especially when they are, you know, eliminating carbohydrates, especially f fibrous carbohydrates.
What should the messaging actually be? Because most doctors are saying, just eat high protein, low carb.
Vic SOLO part ONE: I think that’s a, that’s a great point. And coming from someone who has expertise in this domain, I would defer to that, defer, uh, this to you. But I, I agree with you that sometimes the messaging, uh, has been somewhat, uh, uh, erroneous and erratic in a way that high protein is what you need. Uh, that is, there needs to be a balance and there needs to be all different.
Uh, you know, carbohydrates need to be there, fats need to be there, healthy fats need to be there. So, uh, I think, uh, a, a more optimum ba ballot, uh, messaging needs to happen. Unfortunately, in medicine, uh, [00:10:00] a lot of nutrition edu education is not there and missing. So, um, I would, uh, definitely encourage working with, uh, experts in nutrition and folks who actually, uh, do this my day to day stuff and physicians collaborating with them and educating their patients in what is optimum, what is healthy, what is nutrition and.
Optimizing their targets in terms of weight loss, but as well as ensuring, uh, there’s no, uh, there’s least amount of protein loss and there is no over focus
Supatra solo part ONE: Exactly, and you know, we, we met originally online, but then you invited me to the American Psychiatric Associations Conference, which was amazing. Such an an honor to be able to go there. And one of the keynote speakers was Dr. Dean Ornish, who I just have a, you know, a, a geeky crush on because he’s an amazing, uh, scientist and doctor.
And, um, you know, I think looking into [00:11:00] evidence-based nutrition, uh, studies and work, especially when it comes to overall disease prevention, but also just natural healthy, um, weight loss without dieting is really important, especially when you’re on a GLP one. And if you look at his lifestyle heart intervention, you look at the work of Dr.
Caldwell B Esselstein, um, they really do promote, you know, in terms of the overall healthiest diet that will minimize any disease risk, but also just naturally keep you slim is a whole food, plant-based diet. It doesn’t have to be completely 100% plant-based, but majority plant-based has been shown to really help.
And so that would be my suggestion as a dietician. And I think going to, um, dieticians and nutrition experts that understand the current, um, evidence-based, uh, nutrition is going to be really [00:12:00] helpful for you when you are on a GLP one. I think it’s also really important. Another person that you had at the conference was Dr.
Satchin Panda, and I’m very much geeking out about him. ’cause he was just on my podcast. I was able to meet him and have him on. He does a lot of research in terms of circadian rhythms. He was the one who found the light sensing, um, cell in, in our eyes called melanopsin. Um, and really was kind of the, at the forefront of, you know, blue light, um, you know, damage to our, you know, our sleep and how important setting our circadian rhythm.
When we work in concert with a more of a whole food plant-based diet and we’re really conscious of our circadian rhythm, that actually helps naturally produce GLP one and all of the other appetite suppressing hormones. So I encourage people to go and look into the. The, the work of these people, um, and, and really find out how we can naturally do this because I don’t think it’s hardly [00:13:00] anybody’s goal to be on these medications for life as they are, you know, touted to have to be.
And we don’t have to be, and we actually make our own GLP one. So that would be my suggestion as well. So let’s talk about alcohol. I have a lot of, I’ve seen a lot of questions about alcohol. I’ve also seen in some of the research that people’s desire for alcohol goes down when you’re on GLP ones. Um, what are the concerns around alcohol use when you’re on these medications and what are the specific risks people are not aware of?
Vic SOLO part ONE: Absolutely. So with GLP ones and alcohol, your two systems are in collision. Uh. One, the GLP ones, uh, which are slowing the digestion and blunting the reward pathways while alcohol, which is both a gut irritant and a dopamine shortcut. So physiologically, um, there is slowed gastric ti emptying that is happening, which means [00:14:00] alcohol will hit faster and stronger if someone is consuming alcohol on GLP ones.
Even one drink can cause way more, uh, nausea, dehydration, or dizziness. And, uh, skipping meals and drinking is especially risky, uh, because of blood sugars can dip, the judgment can slip, and the sleep quality can be impacted. Uh, in terms of psychological factors, when the food reward goes down, some people unconsciously replace it with alcohol and seeking the same dopamine hit elsewhere.
That substitution risk is real. So I usually advise a few week period, usually three to four weeks, um, alcohol free, uh, while titrating medication, and then reassessing, uh, if reintroducing, um, alcohol. I recommend pairing with food, hydrating and limiting portions, um, and if someone’s drinking to take the edge off, um.[00:15:00]
Appetite suppression or emotional restriction, then obviously they need a lot more work in therapy and, uh, other supports that they might need. Um, one thing to remember is that the GLP ones do lower appetite, but they don’t raise the alcohol tolerance.
Supatra solo part ONE: So just to be clear, do the GLP ones alter alcohol metabolism? Does it slow the alcohol metabolism itself?
Vic SOLO part ONE: Yeah, so not necessarily, uh, it’s just that it stays longer in the system. Um, and obviously, uh, when there is slowered, gastric emptying, the, the alcohol can hit faster and stronger. Um, and the impacts the absorption can be significant. The other piece is, you know, uh, given, uh, there is decreased, uh, appetite with GLP one.
Um. Folks can feel one more, one drink way more significantly than how they would otherwise feel without the [00:16:00] GLP ones with under eating.
they’re I’ve also heard that the people’s desire for that actually, um, goes down and from, from what I can tell, it’s because we do have GLP one receptors in the brain, and so they seem to be, um, less, there seem to be less cravings for alcohol because of that. Reason. Is, is that pretty accurate?
yes. So, yeah, so regarding the metabolism piece, so it’s, um, not necessarily the metabolism, but yes, the cravings piece, certainly, um, you know, GLP ones are being studied in alcohol use and, uh, other addictions. And, uh, there is, uh, promising data to say that. It can really lower the cravings and the desire for, uh, that repetitive, uh, you know, reward pathway and that goes with the alcohol.
So yes, they
Supatra solo part ONE: So you mentioned delayed gastric emptying, which is a big, um, effect [00:17:00] of the medication. You also mentioned nausea. So I really wanna delve into some of these side effects. Uh, I’m seeing so many people online complaining of hair loss, significant hair loss, nausea. I have seen people have constipation for days.
Um. Sometimes bloody and black stools, vision problems. Let’s talk about symptoms and symptom management. How can we help people who are experiencing such extreme side effects?
Vic SOLO part ONE: Great question. Uh, so these are all real side effects that we see, uh, with patients. Nausea is probably the most, uh, common side effect and uh, basically it’s a signal, right? Uh, the goal is to kind of understand it, respect it, not push through nausea. Um, it does give us some framework also to work with in terms of dosing, timing, [00:18:00] texture, and tempo.
So what is telling us for the dose is like. Going slow and holding or stepping back if the nausea does spike and doesn’t go away. Uh, usually rushing the dosing or rushing the titration upwards causes most issues. Um, also timing wise, uh, some do best dosing in the evenings and sleeping through the peak dose.
Um, also while someone is, um, getting onto the GLP ones or escalating doses the texture of items that they eat or the foods that they eat is, is significantly important. So maybe taking in some small, soft, simple meals like soups, smoothies, lentils, cooked veggies, and avoiding, uh, sugary or greasy foods is critical.
Um, I’ve seen a lot of folks, uh, a lot of patients who are eating fried foods, um, complain a lot more about nausea. So, um, [00:19:00] those greasy foods, uh, definitely tend to trigger more of this. The other piece is, um, the tempo of eating, like eating slowly and sipping through it steadily and moving gently after meals. Um, I’ve also clinically seen that, uh, the nausea is way more significant after each specific dose for a day or so. Uh, so ensuring that, uh. The day that they are going to take the medication, uh, the day off and the subsequent one or two days. Uh, the meal consumption is, uh, somewhat, uh, limited because what can happen with the GLP ones is that when it comes time for the next weekly dose, your appetite can be triggered a little bit and you may actually end up eating a lot more than what you would, um, during, uh, uh, the early phase of the GLP, after the GLP ones have been.
Um, injected. So, um, the day off and the subsequent couple of days are critical, uh, to not eat too [00:20:00] heavily. Uh, the other piece is constipation, sometimes can also masquerades nausea. So fiber and magnesiums, uh, magnesium intake early on are helpful. Uh, sometimes short courses of ginger, um, or anti-acid medications or anti-emetics can help if the nausea persists.
Besides these adjustments. We sometimes pause or reduce the dose even, uh, because the best, best medication is the one a patient can live with. So, um, we, we sometimes have to be very flexible. My mo motto with the medications is to go slow to go far. Uh, so, so really kind of being gentle with the titration.
Uh, sometimes we say, you know, uh, an excitement that we go quickly every week or two weeks. So I’ve seen, uh, best results with gentle titration.
Supatra solo part ONE: Wow. You know, it’s so interesting. I, I personally love your advice and I don’t see that as often as I should see that, uh, you know, there with my clients who [00:21:00] come in after listening to their doctor or psychiatrist or what I see online. And what is so interesting about your advice, uh, Vic, is that that really is wonderful advice for anyone, even if they’re not on the medication. When we follow our circadian rhythm by, you know, trying to wake more when the sun is coming up. Trying to eat more earlier in the day, and focusing on fiber rich meals, most especially in the morning, and then tapering down our food towards the evening, but really focusing on these whole foods throughout the day.
Trying to get adequate sleep, making sure we’re walking and moving throughout the day. All of those things help increase our GLP one, GIP and PYY production. And I love, love, love, and we never hear this eating mindfully. When we actually slow [00:22:00] down, there’s a process in our digestion. Our digestion actually starts with looking at food and our salivation when we are looking at food, when we really slow down.
And here’s the thing, I think a lot of people really become, because of dieting, afraid of hunger. Hunger is not bad. Hunger is is a sign that your body needs nutrition. And I think when we deny that, that’s when we get out of balance with our hormones. But when we eat, when we’re hungry, and we eat slow enough and mindfully enough, we then allow our brain to register the presence of food in our stomachs, and we stop when we’re feeling that satiation and that fullness.
And all of that also goes into hormonal balance. So. We need more psychiatrists like you, Dr. Gupta. We need people who are trained in lifestyle medicine. That’s why I thought that that psychiatric conference, which the focus [00:23:00] was on lifestyle medicine, was so good because doctors, you know, they just don’t get this nutritional advice or, or education in their, um, programs most often.
Um, but you can get it in your continuing ed from people like Vic here. So as a psychiatrist, Vic, how do you see GLP one medications affecting mood, motivation, or body image? Are there some psychiatric red flags that might be missed in a strictly medical weight loss setting?
Vic SOLO part ONE: Great question. Uh, so I see that there are three domains, really, uh, mood, motivation, and self-image. And, uh, GLP can, GLP ones can impact these three in all nuanced ways. Uh, with mood. We’ve seen that some patients feel brighter as the inflammatory processes and their sleep improves. Uh, but also we’ve seen that under fueling or low hydration or caffeine or alcohol [00:24:00] changes can trigger anxiety or irritability in terms of their mood.
Um, in terms of motivation. We’ve seen that the reduced appetite can sometimes free up the mental bandwidth, but we’ve also seen that for a subset of our patient patients that, um, GLP ones, uh, may blunt the drive, uh, they may eat too little and may feel emotionally flat and may complain of feeling down.
Um, as regards to body image stuff, um, rapid physical changes can outpace the psychological adaptation. Patients sometimes struggle to recognize themselves or feel pressure to maintain their results. Um, in terms of, um, red flags to watch out for when someone is on GLP one, um, I think there is one concern for emerging disordered eating, which includes like feeling guilty about food, compulsive trap tracking of food and diet and [00:25:00] meal skipping. The other important, uh, red flag to watch out for is, um, flattening, uh, or affective flattening or irritability or overall depression after dose increases. Um, there could also be substitution behaviors where we, you know, folks use alcohol or stimulants instead of few food. And, uh, there is also, um, on occasion, uh, there is issues with, uh, folks, uh, reporting old trauma kind of resurfacing once food is no longer helping regulate emotions. Therefore, um, I would say with while on GLP ones, uh, a good psychiatric screening at baseline and during, um, those increases is critical. We are also, we are not just treating weight, we are also tending to identify, you know, issues with motivation, emotional safety, and mood.
Um, also remember, um, and I tell my patients. Um, you know, weight is just a number, but the [00:26:00] wellbeing is the most significant and critical fact. And, uh, my job really is to help my patients or author a healthier, uh, you know, narrative for themselves and their efforts.
Supatra solo part ONE: Oh, that’s really great advice. I think we see a lot of these complications too, just in regular dieting. Um, people, especially if they’re consuming very, very, very low carbohydrate, that greatly affects the mood and contributes to anxiety and depression, which is all the more reason why incorporating more whole foods and plants into whatever it is.
If you’re on medication or you’re just wanting to lose weight or increase your health, uh, please do not restrict your carbohydrates, because that’s going to greatly contribute to a poorer mood. And certainly I think there is a lot of confusion that happens for people when they lose their appetite and it’s very difficult
for them to eat very, very difficult for them to even [00:27:00] think about consuming maybe even 800 calories, which is not going to be good for anyone. So if you are experiencing that, you probably should go to your doctor and maybe perhaps lower that dose so that your weight loss is more gradual. It is more healthy, it is more sustainable.
I love this and we’re gonna get more into disordered eating and eating disorders in the second half of this podcast, Vic, but oh my gosh, you have been a wealth of information so far and I am so excited to learn more from you in this second half. So will you come back and join me?
Vic SOLO part ONE: Yeah, looking forward to that. Thank you so very much.
Supatra solo part ONE: and thank you everybody for joining us. Please do come back for the second half of this incredible, informative interview with quadruple board certified psychiatrist and founder of Wellness Psychiatry, Dr. Vikas Gupta.
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