Written by: Dr. Michelle Lesperance, EdD, NBC-HWC, PCC; Dr. Michael Arloski, PhD, NBC-HWC, PCC
Real Balance Global Wellness Services, Inc. February 27, 2025
Background
Glucagon-like peptide agonists (GLP-1) are medications that were initially prescribed to treat diabetes and now have been found to be highly effective weight loss medications. Some are classified as generic
semaglutide medications while others are generic Tirzepatide medications, depending on the mechanism of action (the way they work). One downside of these medications is that they stop working once discontinued.
GLP-1 receptor agonists work by mimicking the GLP-1 hormone, which your intestines secrete when you eat to help regulate blood sugar (glucose).2 Typically, GLP-1 is broken down by other enzymesproduced in the body. The GLP-1 hormone suppresses appetite. The GLP-1 hormone also slows how quickly food leaves your stomach and affects the release of insulin and glucagon from the pancreas.2 By taking a GLP-1 receptor agonist, a patient is supplementing their natural levels of GLP-1, promoting its effects on the body.
When a client expresses interest in GLP-1 medications for weight loss, a coach can play a crucial role offering support throughout the process. The coach must create a “collaborative alliance built on trust, openness, listening and self- awareness”. It is important for the coach to use a holistic approach with clients that want to lose weight, rather than one solely focused on weight loss, especially with GLP-1 medications.
1. Understanding the Client’s Knowledge
The first step is to ask the client:
•What do they already know about GLP-1 medications?
*Affordability, does insurance cover the cost of the medication?
•What do they need to learn?
*Do they know that they have to take them for the rest of their life, or at least long enough to drop sufficient weight and maintain that weight loss through healthy lifestyle habits?
*Do they understand that the FDA now recommends that behavior changes (eating healthy and exercising) are a critical part in the success of long term weight loss?
•How will they gather reliable information?
*Once they have researched the medication, the coach can help them reflect on what they learned and determine their next steps. If their sources are unreliable—such as those funded by pharmaceutical companies—the coach can guide them toward reputable, peer-reviewed information.
2. A Coach’s Role and Limitations
While it is valuable for a coach to have basic knowledge of GLP-1 medications, they should not recommend or prescribe them unless they hold relevant credentials (such as a pharmacist, dietitian, or physician). Instead, their role is to support the client in making informed decisions by:
•Encouraging discussions with healthcare providers.
*Support the client in how to advocate for their own right
•Helping the client understand potential risks and side effects.
*Do they have any concerns?
•Assisting with lifestyle changes that complement the medication.
3. Managing Side Effects and Nutrition
GLP-1 medications can reduce appetite, sometimes leading to unintentional undereating.1 Coaches can help clients:
•Prioritize a nutrient-dense diet, focusing on whole, predominantly plant-based foods and adequate protein intake.
•Recognize and address decreased hunger to maintain proper nutrition.
•Prevent muscle loss by encouraging regular physical activity, increasing intensity and duration as tolerated.2
Other common side effects include nausea, vomiting, and constipation. Coaches can discuss ways to manage these, such as adjusting the timing and location of medication administration.
4. Addressing Emotional and Behavioral Challenges
Weight loss is more than just a physical process—it also involves emotional and behavioral changes. Coaches can:
•Help clients navigate emotional eating and self-sabotaging behaviors.
•Recommend counseling or therapy if needed.
•Support clients in setting SMART goals (Specific, Measurable, Achievable, Relevant, and Time-bound) to keep them on track.
5. Accountability and Ongoing Motivation
Coaches can work with clients to:
•Establish accountability methods for tracking progress. Journaling may help clients not only to reflect on the process of weight loss but also to help build self-awareness and self-reflection skills to enable self-management.
•Provide a supportive space for discussing challenges and setbacks.
•Reinforce the importance of maintaining open communication with their healthcare provider for medical guidance.
By following these steps, coaches can effectively support their clients while respecting professional boundaries and ensuring safe, informed decision-making.
References: 1. Sforzo GA, Gordon NF, Peeke PM, Moore M. Health and Well-Being Coaching Adjuvant to GLP-1 Induced Weight Loss. Am J Lifestyle Med. 2024 Nov 19:15598276241302273.
2.Gillette, H. (May 2024). A guide for deciding if GLP-1 medications are right for you. Available at https://www.healthline.com/health/
