Understanding GLP-1 Medications: A Guide for Health Coaches
Reviewed by Brian St. Pierre, MS, RD
“Is this drug going to steal my job?”
That’s the thought many health and fitness coaches had when GLP-1 medications first hit the mass market.
Though semaglutide (Ozempic) became available in 2017, it initially felt like a theoretical threat. Prescription rates were still very low; it seemed like no one actually knew anyone who was taking it.
Now, in 2026, over 1 in 10 US adults are taking a GLP-1 medication. Most of us know someone on it (or we’re on it ourselves).
With wider use, opinions towards the medication have softened too. Most coaches no longer see it as a threat, and rather appreciate it as a valuable tool for certain clients, with coaching as an additive complement.
Many still have concerns though, primarily about their clients’ long term health on the medication. (Among the worries: Loss of muscle mass! Using a “band-aid” solution! Bypassing foundational health habits! And more!)
However, whether you count yourself as a GLP-1 supporter or a GLP-1 skeptic, there’s a framing that might change the way you think about your work in this field:
“As a coach, you’re not in the GLP-1 world; you’re in the GLP-1 support world.”
That quote comes from Kate Solovieva, Super Coach and PN’s Director of Community. She says that coaches need to recognize that their market isn’t “people on GLP-1s,” but rather “people on GLP-1s who want support.”
Trying to coach everyone taking a GLP-1 just isn’t possible. And spending time thinking about all the people using GLP-1s “the wrong way” is, bluntly, wasted energy. Some of those people just don’t want, need, or aren’t ready for your help.
Meanwhile, there is a subgroup of people on GLP-1s who are ready, willing, and able to receive your support. Honing in on this group is where you can actually make a difference (and where your business can thrive).
In the following article, we’ll cover seven different GLP-1 client “types,” each with their own level of coaching readiness. Based on our experience coaching over 175,000 clients (of which an increasing number are on GLP-1s), we’ll offer strategies to deal with each.
Let’s get into it.
The 7 types of GLP-1 clients
Before we begin, a reminder: People change, and readiness isn’t fixed.
A person who starts off saying “I’m doing fine on my own” may eventually morph into “I’m flailing and really need someone else in my corner”—and vice versa.
If the person in front of you fits into a certain type, that’s their type right now. So listen carefully to how your client speaks at every session, and respond dynamically.
In general, Coach Kate says someone is usually ready for coaching when they demonstrate two things:
- Their issue feels important, urgent, or distressing: Taking better care of their health feels especially valuable right now. (“This really matters to me.”)
- They feel they have the capacity to devote some resources to the issue: Be it time, money, or both, they’re ready to accept some kind of cost. (“I have space to deal with this.”)
Keep that in the back of your mind as you interact with client prospects, and as you read about the client types, which we’ve summarized in the below table.
Client Type #1: The Honeymooner
This is the person who’s started a GLP-1 medication—and they love it.
They’ve experienced minimal side effects, and have gotten great results on a relatively low dose.
They haven’t changed much about their exercise habits or their diet (except the eating less part, which the medication has taken care of), but they’re seeing what they want to see on the scale, so they don’t feel motivated to change anything.
Coaching move:
It might be tempting to “lure” this kind of client in by warning them of the dangers of using a GLP-1 medication without adding in long-term health behaviors (like resistance training and strategic nutrition), but this type of approach can backfire.
At best, you may sound like a downer. At worst, you may sound like an active antagonist.
In Motivational Interviewing, a communication approach commonly used in coaching, this is called the “righting reflex.” It’s the urge that coaches, counselors, and therapists often have to help or “correct course” for their client. You see them doing something “wrong,” and you want to help them “fix” it.
However, following this instinct may actually strengthen a client’s defenses, and prevent change.
If a person is flying high on their current approach, their readiness for coaching is extremely low.
As Coach Kate says, “they’re just not my person yet.”
Your best move with this type is to genuinely celebrate their current results, then plant the seed for support should they need it in the future.
For example, you could say: “It must feel so good to see all these positive results! If you ever feel like you want to work on another layer, like resistance training or optimizing your nutrition, I’d love to work together.”
Then, just stay available. (“My door is always open!”)
Client Type #2: The Ambivalent Candidate
This is the person who hasn’t started a GLP-1 medication—and might never, despite being a great candidate for one.
Maybe their doctor has already suggested the medication to them and they’ve read everything they can on the topic.
And yet, they’re frozen with fear at the starting line. They’re afraid of side effects, of being on medication for life, of not holding up their end of the bargain. (“I’ve been trying to start strength training for years. If I take this medication it matters even more… What if I still can’t do it?”)
Toni Bauer, Super Coach and PN’s Director of Coaching and Education Operations also says that, in some cases, a client’s hesitation isn’t about side effects. “Some of our clients wonder, ‘Am I a good person or a bad person if I start taking a GLP-1 medication? Am I weak? Am I giving up?’” Coach Toni says these concerns aren’t unique to GLP-1 medications, but they seem to be especially common.
She reasons, “If you have high cholesterol, are you weak for taking cholesterol medication? No. But often people don’t view obesity as a disease at a societal level, so the conversation is different here.”
Regardless of the root cause of this person’s hesitation, the advice below can help them find clarity.
Coaching move:
First, let’s be clear: Deciding whether or not to take a medication isn’t a coaching decision, and falls out of your scope of practice. That choice is ultimately up to your client and a medical provider who can assess whether a GLP-1 is appropriate given their medical history.
That said, clients may still come to you wanting to discuss their options.
So the question becomes: How do you support someone through a decision you can’t make for them?
Coach Toni advises: “You can share facts and data. For example, study results and what you’ve seen with other clients. But you can’t say, ‘For you, this is the right choice.’”
Instead, the biggest coaching opportunity here is to help clients articulate what’s actually driving their hesitation.
This hesitation about whether to do something different or stay the same is called ambivalence, and it’s a normal (albeit uncomfortable) stage of change.
Problem is, without the right tools, a person can stay stuck in ambivalence for months or even years. And, much like being stuck at an airport in between two destinations, it sucks.
But at PN, we have a cool exercise to deal with client ambivalence. It’s called the 4 Crazy Questions. Essentially, you explore:
- What’s GOOD about changing?
- What’s BAD about changing?
- What’s GOOD about NOT changing?
- What’s BAD about NOT changing?
In this context, the questions can help a client explore the risk of starting a GLP-1 (which they’ve probably already voiced), but also the risk of not starting, which they may not have considered yet.
Our 4 Crazy Questions worksheet can encourage clients to explore the pros and cons of both choices. With these considerations laid out explicitly, most people feel a lot more clear about their next steps—or at least what questions they need to ask their medical provider before they can move forward.
Importantly, this exercise doesn’t have a “right” outcome. Some people work through it and fill the prescription. Others decide the medication isn’t for them, and that’s fine. (It’s also worth reminding clients that starting isn’t necessarily permanent: With their provider’s input, a trial run on the medication is a perfectly valid way in.)
Either way, there are opportunities to support your client. As Coach Toni puts it: “Whether you go ‘natural’ or whether you go GLP-1, the foundational habits are essentially the same.”
Client Type #3: The Ready-to-Quitter
This is the person who started a GLP-1 with lots of optimism—and now feels like they have a plague that won’t end.
In a cruel twist, this person might actually be seeing great fat loss results. And yet, they’re nauseated, exhausted, dreading their next dose, and wondering whether it’s worth continuing this medication.
Adding to their sense of defeat, they may also be comparing themselves to a “Honeymooner” in their life, so they might also be wondering if there’s something wrong with them. (“It worked so well for my friend! I must be broken in some way.”)
Coaching move:
First, offer some neutral education to depersonalize their experience.
Namely, they should know that side effects are extremely common: About half of users report nausea, a third report diarrhea, and a fifth report vomiting. So, what this person thinks is exceptional might actually just be a normal adjustment. (This doesn’t make the experience suck less, but it can give them some hope.)
Also, getting GLP-1s right is a process of trial and error: the right medication, the right dose, and the right nutritional strategies to reduce symptoms.
If their symptoms are severe, get them to loop in their doctor. Medication type and dosing is under the purview of a medical professional, so involving them is essential.
After that, your best coaching move is to suggest an experiment.
▶ Ask about dose. To be clear, you’re asking about it, not adjusting it. Says Coach Toni: “Often, when people are experiencing extreme side effects, they’ve ratcheted up their dose too quickly. Sometimes the easiest way to keep somebody on a GLP-1 who’s experiencing high side effects is to lower their dosage.” Coach Toni makes clear that while dosage isn’t a coach’s domain, you can help draw a client’s attention to it.
▶ Start a food journal. It doesn’t need to be every day—just around the meals that precede the worst symptoms. You’re looking for three things:
- Fat content: GLP-1 medications slow down digestion. This is what contributes to its satiety effects, but also its side effects at the beginning. Fats also slow down digestion, so high-fat foods and meals (oils, nuts and seeds, and fried foods) can compound symptoms.
- Volume: Again, due to the slowing of digestion, a large meal can feel extremely uncomfortable to digest. A portion that felt normal a month ago may now be far too much at once.
- Random triggers: Spicy foods, tomatoes, chocolate, caffeine. All kinds of foods may trigger symptoms like nausea, acid reflux, or diarrhea in a client who used to tolerate them. These foods won’t always be obvious GLP-1 symptom triggers, so the best way to hunt them down is via a food log.
▶ Try smaller portions, eaten more often. Coach Toni says if you only try one thing, this one is the most reliable strategy. GLP-1 clients may be tempted to cut meals when symptoms are high, but this increases the likelihood of undereating and nutrient deficiencies. The goal, in her words: “Can we get small enough, frequent enough meals that we get nutrients in, but they never feel overwhelmed or super full?”
To stay within your scope of practice, language matters.
Don’t say: “You’re nauseous, so you should eat smaller meals.”
Instead, say: “Folks who are nauseous sometimes do better with smaller, more frequent meals. Want to try it this week and see what you notice?”
In the first example, you’ve offered a “prescription” (which coaches can’t legally do). In the second example, you’ve offered an experiment to consider.
Red flags: When to loop in a medical practitioner
Side effects (such as nausea, vomiting, constipation, and/or diarrhea) are extremely common among GLP-1 users, and typically last one to two weeks after initiating the medication. Some symptoms can last longer (particularly constipation), but most are mild to moderate, and usually improve within a few weeks.
Symptoms can also return each time a dosage is increased, though they’re usually milder and more short-lived. These too tend to improve after the first week or so.
However, you should strongly encourage a client to reach out promptly to their medical provider if they notice:
- Severe or persistent abdominal pain—especially upper-belly pain that radiates to the back, or comes with vomiting or fever
- Right-upper-abdomen pain, fever, or yellowing of the skin/eyes (jaundice)
- Vomiting that keeps them from holding fluids down for 24+ hours
- Dizziness, fainting, or confusion
- Rapid, uncontrolled weight loss or an inability to accomplish basic daily functions
Reassure your client they’re not being dramatic by reporting these symptoms. Their medical team needs to hear this kind of information to help them get the best results, while preserving overall health.
Also: Your client will get better care if they show up prepared. So, get them to jot down and bring:
- Symptoms they’ve noticed and roughly when they started
- How daily life is affected—eating, energy, mood, workouts
- What they’ve already tried, and what helped (if anything)
- Rough daily intake and protein, if they’ve been tracking
- Specific questions they want answered before they leave
Client Type #4: The Muscle-Loss Risk
This is the person whose results look great, but less visible changes are creating longer term risks.
This person is likely to be quite sedentary, and when you ask what they do for exercise, they might tell you “I walk.” But they’re not the outlier type who consistently gets 20,000 steps a day. They just… walk a little.
Women are more likely to fall into this category, especially if they come from a generation or culture where strength training simply wasn’t a thing women did (or were welcomed to do).
Additionally, this person might be running on a decades-long plain-toast-and-coffee breakfast habit, with lower protein intake already ingrained before medication further reduced appetite.
The scale is dropping though, so they’re thrilled. It’s just that nobody’s measuring what kind of weight is dropping.
Coaching move:
Your job is to bring awareness to the invisible. Because once this person sees what’s at stake, they’ll be more likely to see the value in changing their habits, and in coaching.
However, theoretical warnings about muscle loss are easy to dismiss.
This is one of the reasons why Coach Kate says, “I don’t care if I coach you or not—please just get a DEXA as a baseline.”
When a person has a quantifiable, objective measure of their muscle composition, it’s often more motivating than any amount of abstract concern.
Ideally, every person who begins a GLP-1 medication should get a DEXA scan before they start, then again at six or twelve months to see how they’re progressing.
If a client can’t or won’t do a DEXA, assess strength and function in other ways. Ask: “How do the stairs feel compared to a few months ago? What about carrying groceries?” Gather objective data too, recording baselines for squat, deadlift, and bench press (or other accessible exercises) to compare to over time. Declines in any of these areas can reveal potential muscle loss, and can motivate a client to take action.
Without protective strategies, up to 40 percent of weight lost from GLP-1 medications can come from lean mass, with a majority of that being muscle.
In order to prevent that from happening, there are two behaviors to prioritize:
- Protein at every meal. When appetite is suppressed, every bite has to earn its place. Aim for 25-40 grams of protein at every meal and