Coaching clients on GLP-1s is quickly becoming one of the most common (and most avoided) conversations in this industry. If you’ve got a client on Ozempic, Wegovy, or Zepbound right now, you’ve probably wondered where that leaves you. Here’s the truth: research suggests most people who start a GLP-1 for weight loss stop taking it within a year. The medication can quiet appetite. It can’t teach someone how to eat under stress, rebuild consistency after a bad week, or stay engaged with their goals once the effect changes. That gap is exactly where your coaching still matters, and honestly, matters more than it did before.
🎯 Doors are open for the Fall 2026 cohort of The Health Mindset Coaching Certification. Brooks and Greg, the two program mentors on this episode, both started exactly where you might be right now, unsure how to coach through the stuff that doesn’t have a clean answer (GLP-1s included). Enrollment is open now → ENROLL HERE!
In this episode of Not Another Mindset Show, I’m joined by two of my HMCC program mentors, Brooks and Greg, for a wide-ranging conversation on where coaching is heading. One of the pieces I want to pull out here: what GLP-1s actually mean for your coaching, what the research says about how long people stay on them, and how to have this conversation with a client without either dismissing the medication or leaning on it too hard.
If you’ve got even one client on a GLP-1 right now (or you’re bracing for the conversation to come up), this one’s for you.
What You’ll Learn in This Episode
- What the research actually says about how long people stay on GLP-1 medications
- Why weight loss alone doesn’t solve the follow-through problem
- What happens to a client’s habits when the medication’s effect starts to fade or ends
- How to talk to a client about their GLP-1 without competing with it or ignoring it
- Where your scope of practice starts and ends in these conversations
Are GLP-1s Making Coaches Obsolete?
No. But I get why it feels that way, and I’d rather name that directly than dance around it.
Greg, one of the mentors on this episode (co-owner of Evolve 2 Excel Nutrition and Performance, with over 1,300 clients across a decade of coaching), said it plainly: the results are in, and GLP-1s are likely the most effective weight-loss tool available right now. That’s not something worth arguing with. Pretending otherwise doesn’t help your clients and it doesn’t help your credibility.
What’s also true: a medication that turns down food noise doesn’t teach anyone how to eat consistently when work is chaotic, or how to keep showing up after they’ve fallen off for a week. That was never what it was built to do.
How Long Do Coaching Clients Stay on GLP-1s?
This is the part coaches tend to get wrong in one direction or the other, either assuming clients will be on these forever, or assuming they’ll quit fast and there’s nothing left for you to do.
A 2025 study in JAMA Network Open followed more than 125,000 US adults who started a GLP-1 for overweight or obesity. The findings: 64.8% of patients without type 2 diabetes discontinued within the first year, compared to 46.5% of those with type 2 diabetes (Rodriguez et al., 2025). Weight regain after stopping was strongly tied to restarting the medication, and side effects and insurance coverage were among the biggest drivers of people quitting.
A separate 2025 analysis out of Denmark found similarly high first-year drop-off among semaglutide users, with cost and side effects cited again as the main reasons.
Translation for your coaching: most of your clients on a GLP-1 for weight loss, statistically, are more likely than not to be off it within a year. That’s the off-ramp Greg talked about on the episode, and it’s not really a medical off-ramp. It’s a behavioral one.
Coaching a Client Off Their GLP-1s: What Happens Next
This is where I want you to really sit with the mentor perspective on this episode, because it’s not hypothetical for either Brooks or Greg. It shows up in their coaching regularly.
Brooks (owner of Sweat Simple Coaching) shared that it’s rarely a clean decision. Insurance coverage changes. A client chooses to come off it. Or the dosage that used to work stops working as well, and food noise starts creeping back before they’ve even fully decided to stop.
None of that gets solved by the medication itself. It gets solved by whether the client built real skills alongside it, or whether the appetite suppression was doing all the work while nothing underneath actually changed. That’s likely why weight regain is so strongly tied to people restarting the medication in the research above. If the behavior never changed, coming off it just means going back to what was already there.
Coaching Clients on GLP-1s: What to Say (and What to Avoid)
A few things Brooks and Greg both hit on in this conversation:
- Don’t treat it like competition. Both of them frame it as one tool in the client’s toolbox, not a replacement for you. “We’re working with this together” keeps a client engaged. Feeling like they need to hide it from you does the opposite.
- Build the off-ramp early, not after the fact. If a client’s on a GLP-1, that’s the moment to start building the habits they’ll need for when the effect changes, not after they’ve already regained weight and lost confidence.
- Watch for over-reliance. If you hear something like “I don’t know what I’ll do if I have to come off this,” that’s worth getting curious about. It’s often the same fixed-mindset pattern that shows up whenever a client leans too hard on any single tool.
- Stay in your lane. You’re not managing dosage or making medical calls. Your job is the behavior change happening around the medication, which is exactly what it was never designed to teach.
Why “Effective” Doesn’t Mean “Solved” (The Real Job of Coaching Clients on GLP-1s)
This connects to something I come back to constantly inside The Health Mindset Coaching Certification: something working in the short term doesn’t mean the underlying behavior change has actually happened. At its core, coaching clients on GLP-1s is the same job as coaching any client through any tool. It’s building what holds up once the tool’s effect changes. Self-determination theory (Deci & Ryan) is a useful lens here. Follow-through that leans on something external, whether that’s a medication reducing appetite or a plan someone else wrote, tends to be more fragile than follow-through built on a client’s own internal skills. When the external support shifts, the behavior often shifts with it, unless something else was built underneath it.
That’s not a knock on GLP-1s any more than it’s a knock on a good meal plan. It’s the same argument I’ve made about plans for years, just pointed at a newer tool.
Key Takeaways
- Coaching clients on GLP-1s comes down to one thing: building the skills the medication was never designed to teach.
- Research suggests most people using GLP-1s for weight loss discontinue within a year, more so than those using it for diabetes management.
- Weight regain after stopping is strongly linked to restarting the medication, which suggests the underlying behavior often didn’t change while on it.
- GLP-1s don’t teach consistency, stress-eating skills, or follow-through, which is exactly the gap your coaching fills.
- The best time to build a client’s off-ramp skills is while they’re still on the medication, not after they’ve come off it.
- Your scope is the behavior change around the medication, not managing the medication itself.
Frequently Asked Questions About Coaching Clients on GLP-1s
Will GLP-1 medications put health and fitness coaches out of business?
No. Research suggests most people who start a GLP-1 for weight loss discontinue it within a year, and even while on it, the medication doesn’t build the skills clients need for consistency and follow-through. Coaches who only hand out macros and workout plans are more at risk. Coaches who teach the mindset and behavior side of things remain hard to replace.
How long do most people stay on GLP-1 medications like Ozempic or Wegovy?
A 2025 study in JAMA Network Open found 64.8% of adults without type 2 diabetes and 46.5% with type 2 diabetes discontinued GLP-1 treatment within their first year, largely due to side effects, cost, and insurance changes. This research area is moving fast, so it’s worth checking current figures periodically.
Should I keep coaching a client after they start taking a GLP-1?
Yes. A GLP-1 can reduce appetite, but it doesn’t build the skills a client needs to eat consistently under stress or sustain habits long-term. Staying engaged during this period, with an eye toward what happens if the medication’s effect changes, often matters more than at any other point in the coaching relationship.
What should I do if my client’s GLP-1 stops working as well or they lose coverage?
This is common, which is exactly why building skills early matters. If a client hasn’t developed consistency habits alongside the medication, this transition can feel destabilizing. Revisit their eating patterns and stress tools proactively instead of waiting for a crisis, and treat it as a normal part of coaching rather than a setback.
Is it within a coach’s scope to talk to clients about GLP-1 medications?
Coaches can talk with clients about their experience on a GLP-1 (side effects, changes in hunger, how they feel about being on it) without managing dosage or giving medical advice, which stays outside scope of practice. The coaching conversation stays focused on behavior, mindset, and habits around the medication, not the medication itself.
Links & Resources
Are GLP-1 Medications Putting Coaches Out of Business? | EP 87
Will ChatGPT Take Over Health and Fitness Coaching? | EP 74
Identifying a Fixed Mindset In Clients (And Coaches) | EP 53
Health Mindset Coaching Certification
Follow Dr. Kasey Jo on Instagram: @drkaseyjo
AUTHOR BIO
Dr. Kasey Jo Orvidas, PhD is a published mindset and health behavior change researcher with over a decade of health and fitness coaching experience. She is the founder of the mindset and behavior change coaching program: The Health Mindset Coaching Certification.
