GLP-1s: Is the Medicine Alone Enough?
If you’re one of the millions of Americans taking a GLP-1 medication, you may feel a wave of relief that help has finally arrived. And no wonder. Losing weight can be one of the most difficult challenges we face.
It Was Never Just Willpower
We’ve been told over and over that weight loss is a simple matter of calories in, calories out. But that’s only a sliver of the story.
If shedding pounds were as simple as we’ve been made to believe, we’d all quickly and easily reach our desired body size. It’s hardly a lack of desire that stands in our way.
Calories absolutely play a role. But so do hormones, genetics, lifestyle, your environment, how you were raised, past traumas, the beliefs you hold about yourself, chronic stress, and a body hard-wired to protect itself from anything that looks like famine.
We all know people who seem to eat anything they want and maintain a healthy weight. Full disclaimer: I’ve enjoyed the privilege of belonging to this group. And that’s a good thing because I learned early on that willpower might get you going, but it requires far too much energy to combat all the mighty forces working against you, called daily life.
What the Medication Doesn’t Do
GLP-1 medications, prescribed and monitored by a provider, are indeed a godsend for many. They can help you eat less and quiet the food noise. But they’re not a panacea; they don’t automatically teach you how to eat better, find ways to cope with stress, or build better habits that actually fit your life.
The journey also comes with its own challenges. Those taking these medications may still face poor nutrition, loss of strength and muscle, dehydration, stomach troubles, fear of regaining weight, shame, and shifts in identity or relationships. Some of these are questions for your prescriber. Others play out in everyday life, long after the appointment ends.
The Support Gap
As it stands, and through no fault of their own, few healthcare providers who prescribe GLP-1s have time to offer the ongoing, individualized support that lasting change requires. So who takes on that role? A friend? A relative? Do you figure it out yourself? Or do you end up going without support altogether?
Where a Health and Wellness Coach Fits
This is the terrain of a health and wellness coach. We offer non-judgmental support, accountability, and practical tools for the day-to-day. We help you untangle issues that come up along the way, build lifestyle habits that support your treatment, and give you a sounding board for any emotions that may surface. Should something call for a different kind of support, like a therapist or a dietitian, we help you find it.
To be clear, we don’t prescribe, diagnose, or replace your medical team. We work alongside them, so the progress you make has something solid to stand on.
Our role also isn’t to sit back and tell you what to do. A plan handed to you is a fish. We’d rather help you learn to fish: tapping into the wisdom you’ve had all along, seeing yourself in a different light, and bringing out your best, whatever that may be.
“Most patients who start GLP-1 medications will discontinue use, and without meaningful behavior change, there is a high probability of weight regain.”
What the Research Says
A 2024 paper in the American Journal of Lifestyle Medicine says it all.
“The GLP-1 revolution is upon us and millions of patients will be prescribed these medications in the next 5-10 years. GLP-1 use promises substantial weight loss and a myriad of other health benefits with most these claims increasingly supported by research evidence. It is likely HWC professionals will soon be working with patients using GLP-1 medications if they are not already.
Most patients who start GLP-1 medications will discontinue use, and without meaningful behavior change, there is a high probability of weight regain. Lifestyle and mindset changes are vital for GLP-1 patients and HWC is an intervention option demonstrated to benefit patients with obesity. There are specific HWC tools and strategies to emphasize when working with obesity. A strong patient-centric coaching relationship and key coaching skills are essential to an effective intervention.
GLP-1 medications are proven effective and will be highly successful obesity treatments for many patients over the initial 12-24 months. However, this short-term success is optimally used to catapult the patient to sustained long-term health and well-being. Behavior changes and sustained lifestyle habits are essential to long-term GLP-1 prescription success. HWC is expected to be an effective adjuvant intervention to GLP-1 treatment, making sustainable achievement of weight loss and health goals more possible than ever before.”
Gary A. Sforzo, Neil F. Gordon, Pamela M. Peeke, and Margaret Moore, American Journal of Lifestyle Medicine (Volume 19, Issue 4) pp. 652–660. Copyright © 2024 by The Author(s). Reprinted by Permission of Sage Publications.
The authors make the case for health and wellness coaching alongside GLP-1s. Coaching has already been shown to help people stick with their medications and make lasting changes. They’re also honest that the pairing itself still needs to be studied head-on. But the logic holds: the medication changes your appetite, and coaching helps you change your life around it.
So, Is the Medicine Alone Enough?
For some, maybe. For many of us, having additional support can make a difference. The medication can open the door. What you build on the other side is up to you, and you don’t have to build it alone.
Source: Sforzo GA, Gordon NF, Peeke PM, Moore M. Health and Well-Being Coaching Adjuvant to GLP-1 Induced Weight Loss. American Journal of Lifestyle Medicine. 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11577329/
