What Health Coaches Need to Know About GLP-1 Agonists

Introduction to Health Coaching and GLP-1 Agonists

GLP-1 agonists, also known as glucagon-like peptide-1 agonists, are a class of medication that mimics the action of the naturally occurring GLP-1 hormone, which has several essential roles in the body. GLP-1 helps trigger insulin release from the pancreas, blocks glucagon secretion (which raises blood sugar levels), slows stomach emptying, and increases the feeling of fullness after eating. By promoting weight loss and improving blood sugar control, GLP-1 agonists play a crucial role in diabetes management.  Some formulations are also approved for the treatment of overweight and obesity.

With this in mind, health coaches should be aware of a handful of implications to coaching clients that are utilizing GLP-1 agonists.

Best Practices for Health Coaches

Although the following list is not exhaustive, it provides you with the foundational strategies for effectively and safely coaching clients using GLP-1 agonists while also staying within your scope. While the primary health coaching principles and techniques remain the same (i.e. motivational interviewing, appreciative inquiring, etc.), there are a few things to take into consideration that may differ when working with clients on GLP-1 agonists. However, the primary health coaching principles and techniques remain the same such as motivational interviewing and appreciative inquiring.

Protein Intake

When taking GLP-1 medications, it’s essential to pay attention to protein intake. There are some guidelines for protein requirements. The first is people should aim for at least 70 to 75 grams of protein per day. This helps prevent muscle loss that can occur during weight loss. In a high-protein diet, 25%-35% of calories should come from protein. For example, if someone consumes 1,600 calories a day, this translates to 100-140 grams of protein daily. Of course, please work with a registered dietitian to confirm the appropriate grams of protein needed.

Look for protein sources with at least 15 grams of protein per serving. Some clients may want to consider adding protein powder to some meals. It is convenient and provides a good protein boost. Options with a short ingredients list and limited added sugars, such as 100% whey, soy, or pea protein, are always best.

Strength Training

Strength training plays a crucial role when using GLP-1 agonists. GLP-1 medications can help suppress appetite, leading to fewer calories consumed and weight loss. The goal with the weight loss is to lose body fat and preserve muscle mass. Strength training helps to maintain muscle mass, preventing muscle loss during weight loss.

When it comes to long-term weight management, strength training is important too. Consistent strength training sets someone up for sustainable weight management. Especially beyond the GLP-1 agonist journey. With strength training, it can help ensure a healthier and effective transformation.

Side Effect Considerations

Side effects can happen at any time and may impact the lifestyle habit goals your client is working on. With empathy, health coaches need to understand there may need to be an opportunity to pivot quickly to “Plan B” when considering the following side effects:

Common Side Effects:

• Nausea: Feeling sick is a common side effect associated with GLP-1 agonists. However, this usually improves over time.
• Diarrhea: Some people may experience diarrhea when taking these medications, but it tends to resolve with continued use.
• Vomiting: Vomiting can occur, especially when starting treatment, but it often diminishes over time.
• Decreased Appetite: GLP-1 agonists can reduce appetite, which may contribute to weight loss.

More Severe Side Effects:

• Low Blood Sugar (Hypoglycemia): While less common, hypoglycemia is a serious risk associated with GLP-1 agonists.
• Stomach Pains: Some individuals may experience abdominal discomfort.
• Skin Reactions: If they inject the medicine, there’s a possibility of skin reactions.

Holistic Approach

Though this may not be a surprise to health coaches, we need to take a holistic approach to someone’s health and well-being; it’s not just about diet and exercise and coaching individuals that take GLP-1 agonists are no exception. Our lifestyle habits are interconnected. For example, if someone does not sleep well, they may choose higher sugar foods and skip their workout. Pillars such as sleep, stress management, substance, use, social support, spiritual, and environmental aspects of someone’s life are important to consider when trying to help guide them to a more balanced and vivacious life.

Coaching Program Length and Frequency

Individuals on GLP-1 agonists are typically on them for a minimum of three months and it is not unheard of for them to be on them for 24 months or more. This will impact how long a coaching program should be. Typically, health coaching programs for this population are a minimum of four months and have been seen to be as long as two years.

The frequency of coaching sessions is observed to be biweekly typically. Those that did coaching paired with GLP-1s agonist for one year observed an average 15.6% weight loss. In the second year, people lost an average of 16.8% body weight. Aside from just weight loss, GLP-1 coaching programs have also observed an improvement in lipids, A1c, liver function test, insulin, and hs CRP.

It is important to note what happens between coaching sessions. Check-in messages between sessions are common. This is helpful to drive motivation and accountability. Sessions paired with between session communication makes for a well-rounded support structure.

Sources

GLP-1 Agonists: What They Are, How They Work & Side Effects (clevelandclinic.org)

Considering GLP-1s: A Guide to Deciding If It’s Right for You (healthline.com)

Considering GLP-1 medications? What they are and why lifestyle change is key to sustained weight loss | Mayo Clinic Diet

GLP-1 agonists: Diabetes drugs and weight loss – Mayo Clinic

Combined GLP-1 medication and virtual coaching leads to sustained weight loss | Cleveland Clinic Journal of Medicine (ccjm.org)

How to Combat Muscle Loss While Taking GLP-1s | Omada Health

https://diet.mayoclinic.org/media/bqqhmul0/protein-balance-for-glp1s-sample-meal-plan.pdf

A holistic approach to integrative medicine – Mayo Clinic Press

Brittany Kowalski Director of Client Solutions

Brittany Kowalski was one of the very first Nationally Board-Certified Health and Wellness Coaches in the country and earned her original certification through the University of Delaware’s Graduate program.While sports medicine was her first passion, she became drawn to preventative approaches with her patients and threw herself into learning ways to help motivate people to manage and prevent chronic diseases. Her diverse experiences as a health promotion specialist including diabetes lifestyle coaching, mental health initiatives, and even laughter therapy programs, have allowed her to walk beside and help guide people on their wellness journeys. Over her career, she has been sought out as an expert in the field of Health Coaching including speaking opportunities for the American Diabetes Association, the Medical Affairs Professionals Global Conference, Rutgers University, American College of Preventative Medicine, and the National Wellness Conference.In addition to her work as a clinician, she has also helped to initiate health coaching programs in various large-scale hospitals across the nation with focuses on cardiometabolic, pulmonary, bariatric, and physical therapy.

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