GLP-1 medications like Ozempic, Wegovy, and Mounjaro are making waves in weight loss and diabetes management, but relying solely on a prescription isn’t enough for lasting health. 

True success for clients on these medications comes from pairing the power of medication with sustainable lifestyle changes. This is where health coaches play a pivotal role—helping clients navigate the path to long-term, meaningful transformation.

A recent study by Donna Ryan, MD, presented at the 2023 Obesity Week annual meeting, underscores the importance of combining GLP-1 receptor agonist medications with intensive lifestyle interventions to achieve sustained weight loss. The research demonstrated that integrating these medications with behavior-focused, real-world interventions—like one-on-one coaching sessions, small lifestyle adjustments, and the use of digital tracking tools—can lead to long-term weight loss. 

The combination of GLP-1 therapy and lifestyle changes resulted in an impressive average weight loss of 15.6% over 12 months, with results maintained up to 24 months. (1) This highlights the critical role of behavior change in ensuring the lasting impact of GLP-1 medications.

However, a significant disadvantage of using these medications is the high rate of weight regain when they are discontinued. As effective as GLP-1 medications are during active treatment, once clients stop using them, the risk of weight gain often increases significantly. This creates a cycle where clients may regain the weight they lost, making it crucial to emphasize the importance of weaning off the medication in a controlled and gradual manner, alongside the continuation of healthy lifestyle practices. Achieving success with pharmacologic treatment and then transitioning to a sustainable, long-term weight maintenance strategy, without relying solely on medication, would be ideal for lasting health. (2)

Despite the clear benefits of combining medications with intensive lifestyle support, fewer than 2% of qualifying adults receive obesity pharmacotherapy, and even fewer are paired with the necessary lifestyle interventions to maintain weight loss. Barriers like limited insurance coverage, high medication costs, and a lack of physician training in obesity management contribute to this gap in care. (1) 

This is where certified health coaches make a profound difference. Health coaches help bridge this gap by offering ongoing weight management support, guiding clients in nutrition, physical activity, mindset shifts, and emotional health—key factors in sustaining weight loss and improving overall well-being.

A Key Concern: Muscle Loss During Rapid Weight Loss

A key concern with rapid weight loss, particularly with GLP-1 medications, is muscle loss. When weight drops quickly, the body may break down muscle tissue for energy, reducing lean muscle mass. Without resistance training, up to 35% of weight loss can come from muscle mass, which can slow metabolism and increase the risk of weight regain. 

This is problematic because muscle is essential for strength, mobility, and metabolism. Preserving muscle mass during weight loss is vital for maintaining a healthy metabolic rate, preventing a rebound in weight gain, and supporting functional health as we age.

Health Coach Strategies to Support Clients on GLP-1s 

Clients using GLP-1 medications require a holistic approach that targets the root causes of metabolic dysfunction rather than relying solely on medication. While these medications help control appetite and promote weight loss, they don’t address the underlying factors that affect long-term metabolic health. To achieve lasting results, clients must develop healthy habits that go beyond just taking medication. 

Health and wellness coaches play a key role in supporting clients on GLP-1 drugs by guiding them toward sustainable lifestyle changes that improve overall health and address the root causes of metabolic imbalance. (3)

Nutritional Considerations

Nutrition plays a vital role in preserving muscle and promoting overall health, especially during weight loss. One of the most important considerations for clients on GLP-1 medications is optimizing protein intake. Since rapid weight loss can lead to muscle breakdown, ensuring clients consume enough high-quality protein will support muscle repair and maintenance.

Coach GLP-1 weight loss clients to choose protein-rich foods such as:

  • Lean meats
  • Fish
  • Eggs
  • Beans
  • Tofu 
  • Quinoa

In addition to protein, it’s essential to emphasize the importance of balanced meals. Clients should aim for a mix of lean protein, healthy fats, and fiber-rich carbohydrates in every meal to keep blood sugar levels stable and promote sustained energy. 

Hydration also plays a crucial role in overall well-being. Encouraging clients to drink water regularly throughout the day can improve digestion, support energy levels, and reduce cravings.

Additionally, gut health is a foundational part of overall health and weight management. Certified health coaches can support clients by encouraging fiber and fermented foods, which aid in digestion and may reduce bloating.

Physical Activity & Strength Training

Physical activity is an essential piece of the puzzle, especially for preserving muscle mass during weight loss. Resistance training, or strength training, is critical for clients on GLP-1 medications. As the body loses fat, it’s important to maintain muscle mass to help prevent a slowdown in metabolism and loss of strength, which are common challenges occurring with weight loss, particularly when using GLP-1 medications. 

Strength training promotes muscle growth, improves bone density, and supports metabolic health, which is especially important when dealing with the side effects of rapid weight loss.

Health coaches can collaborate with personal trainers on how to help clients on semaglutides with a comprehensive approach to fitness and well-being. Personal trainers can design customized workout plans focused on resistance exercises, such as weightlifting, bodyweight movements, and resistance bands, while health coaches support clients in building sustainable habits and mindset. 

It’s important to begin exercise gradually, particularly for clients new to strength training, and focus on consistency rather than perfection. Regular movement—ideally two to three times a week—can significantly preserve muscle mass, enhance metabolism, and support long-term weight loss goals. This collaborative effort ensures that clients receive holistic support for both physical and behavioral transformation.

Mindset & Emotional Eating

One area that GLP-1 medications don’t address is emotional eating and the psychological aspects of weight loss. Many clients struggle with unresolved emotional relationships with food, which the medication won’t fix. Coaching helps clients explore these emotional triggers and guide them toward healthier ways of coping with stress, boredom, or anxiety without turning to food.

Supporting mindful eating is one approach that can help clients improve their eating habits. Encouraging clients to honor their hunger and fullness signals, without judgment, helps build a balanced, positive relationship with food. 

Body image is another critical aspect of this journey. As clients lose weight and reshape their bodies, coaches provide support by fostering self-compassion and promoting a positive mindset. Practicing mindfulness and cultivating gratitude for what their bodies can do, rather than just focusing on appearance, can make a huge difference in how clients feel about themselves and their progress.

Health coach strategies to support weight management include mindfulness exercises, journaling prompts, or cognitive reframing techniques to help clients identify emotional eating triggers. For example, teaching clients to pause and check in with their emotions before eating can help break the cycle of mindless eating, offering clients a sense of empowerment over their behaviors.

By addressing mindset and emotional eating, coaches guide clients toward a healthier, more sustainable approach to weight maintenance that focuses on long-term well-being rather than temporary results.

Working in Collaboration with the Medical Team

While health coaches don’t prescribe or manage medications, they play an essential role in supporting clients alongside their medical team, which may include doctors, dietitians, and therapists. Certified health coaches help ensure a coordinated approach to the client’s care by fostering open communication between the client and their healthcare providers. This collaboration allows for a more holistic treatment plan that addresses both the medical and lifestyle aspects of health.

Health coaches must remain mindful of their ethical boundaries and scope of practice. Coaches should focus on behavior change, mindset, and lifestyle habits while respecting the expertise of other healthcare professionals. 

In addition, coaches must be attentive to signs of eating disordered behaviors, such as restrictive eating patterns, unhealthy body image fixation, or disordered thoughts around food. In such cases, coaches need to refer clients to licensed mental health professionals or specialists in eating disorders to ensure that they receive the appropriate care.

By collaborating effectively with medical teams and adhering to ethical guidelines, health coaches empower clients to take an active role in their health and well-being. This approach ensures clients receive the support they need for long-term success while prioritizing their safety and overall well-being.

Helping Clients Turn Short-Term Weight Loss into Lifelong Wellness

GLP-1 medications can be a valuable tool in the weight loss and diabetes management journey, but true, lasting transformation requires more than a medication. Health coaches are indispensable in helping clients make the behavioral and mindset shifts necessary to maintain their progress and achieve long-term health. By working together with clients and their healthcare teams, coaches help ensure that clients not only lose weight but gain a healthier, more sustainable way of living.

As a certified health coach, it’s crucial to educate yourself and empower your clients holistically—supporting them not just through medication but through personalized strategies in nutrition, exercise, mindset, and emotional well-being. By mastering these skills, you can provide comprehensive support to clients on GLP-1 medications, ensuring their success lasts long after the prescription bottle is empty.

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FAQs: Coaching Clients on GLP-1 Medications

1. Do clients on GLP-1 medications still need health coaching?
Yes—absolutely. While these medications help with weight loss, they don’t teach long-term habits. Health coaches help clients build sustainable routines around nutrition, exercise, and mindset so the results actually last.

2. Can health coaches help prevent muscle loss during weight loss?
Yes. By encouraging resistance training and proper protein intake, coaches can help clients protect muscle while losing fat—especially important with rapid weight loss from medications like Ozempic or Wegovy.

3. What’s the coach’s role if a client is working with a doctor?
Coaches don’t replace medical care—they complement it. You support the client’s daily habits, mindset, and motivation while respecting the doctor’s medical plan. It’s a team effort!

4. Why do some clients regain weight after stopping GLP-1s?
Because the habits that help maintain weight loss weren’t built. Without healthy routines, it’s easy to fall back into old patterns. That’s why coaching through the off-ramp is so important.

5. Do health coaches talk about emotional eating with clients on GLP-1s?
Definitely. GLP-1s reduce appetite, but they don’t address why someone eats when they’re bored, stressed, or sad. Coaches help clients build awareness and healthier coping tools.

6. How can I learn to support clients on weight loss medications?
ISSA’s HCI Pathway Program will teach you how to guide clients holistically—through behavior change, fitness, nutrition, and mindset—so they succeed with or without medication. Start your journey to becoming a National Board-Certified Health & Wellness Coach and learn how to coach confidently and elevate your career to the next level.

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References

  1. Cleveland Clinic Journal of Medicine. (2023). Combined GLP-1 medication and virtual coaching leads to sustained weight loss. Cleveland Clinic Journal of Medicine. Retrieved from https://www.ccjm.org/page/obweek-2023/GLP-1-weight-loss
  2. Rausch, P., & DiBonaventura, M. (2023). Weight reduction with GLP-1 agonists and paths for discontinuation while maintaining weight loss. MDPI. Biomolecules, 15(3), 408. https://doi.org/10.3390/biom15030408
  3. Sforzo, G. A., Gordon, N. F., Peeke, P. M., & Moore, M. (2024). Health and well-being coaching adjuvant to GLP-1 induced weight loss. American Journal of Lifestyle Medicine. Advance online publication. https://doi.org/10.1177/15598276241302273

Brooke Jeffries

By: Brooke Jeffries

Brooke Jeffries is the Lead Instructor and Program Director of the HCI Pathway Program. With a wealth of knowledge in nutrition, health, and coaching, Brooke is a Certified Nutritionist, National Board-Certified Health & Wellness Coach, and an advisor on the National Board for Health and Wellness Coaching Program Approval Commission. Her passion for personal growth is infectious, and her expertise is unparalleled.