5 areas to consider when using GLP-1 beyond a lower number on the scales

GLP-1 medications have changed the conversation around weight management and offer a level of weight loss that has previously been difficult to achieve. But it is not just about achieving a lower number on the scales.

Amid the many studies and recommendations, the World Health Organisation’s December 2025 guideline explicitly recognises obesity as a chronic disease requiring lifelong care. It also recommends considering behavioural and lifestyle support alongside GLP-1 medications and calls for comprehensive, person-centred care.

A whole-person approach is important because weight is only one aspect of health. Changes in appetite and body weight can affect nutrition, muscle strength, emotional wellbeing and a person’s relationship with food. People also have different reasons for taking medication and different circumstances to navigate. Looking at the bigger picture can help ensure that care considers not only weight loss, but also overall health, everyday life and what happens in the longer term.

Here are five areas to consider when taking GLP-1 medication.

1) What is the benefit beyond the scales?

It is important to be clear about why someone is taking GLP-1 medication and to look beyond the number they want to see on the scales. Everyone will have their own ‘why’: the reason they started taking the medication in the first place.

Perhaps it was to reduce the risk of other chronic illnesses, to be able to play with their children or grandchildren, or to feel more confident in themselves.

Whilst losing weight can help to some extent, it will not always get someone the whole way there. Until people are clear on their ‘why’ and understand their ultimate motivation, it can often be difficult to commit to the areas outlined below.

People can explore this for themselves by asking three ‘why’ questions:

• Why are you taking GLP-1?
• Why is that important to you?
• And why is that important to you?

2) Healthy eating

One of the most noticeable effects of GLP-1 medication is a reduction in appetite. For some people, this can make it surprisingly difficult to eat regular meals or consume enough nutrients. When hunger is less prominent, it is easy to focus on eating less without giving sufficient attention to what the body still needs.

Those taking GLP-1 will need to establish realistic meal routines, recognise patterns in their eating and work towards a balanced, nutrient-dense diet. This may include practical strategies for managing smaller meals, planning ahead and making food choices that provide adequate nutrition.

Protein, fibre, vitamins, minerals and hydration all deserve attention, although individual needs will vary. If people have complex dietary requirements or persistent gastrointestinal concerns, they should seek advice from a registered dietitian or GP as appropriate.

When someone is taking GLP-1 medication, the aim is not simply to eat less. It is to help make the food they do eat count.

3) Preserving strength, muscle and physical function

Weight loss does not come exclusively from body fat. Some muscle may also be lost, which makes maintaining muscle and physical function an important consideration during treatment.

It is important to build movement into everyday life and, where appropriate, follow an exercise plan to help retain muscle and potentially develop more. For example, this may include working towards resistance training and gradually increasing activity in line with individual ability.

Find an exercise plan that works for you, taking into account your exercise preferences, lifestyle and the time you have available. Everyone will have their own barriers to exercise, and it is important to work out what these might be and how to overcome them.

After all, an idea without a plan is just an idea.

Success with GLP-1 should not be measured only in kilograms lost. Being able to climb stairs more comfortably, carry shopping, walk further or feel physically stronger can be just as meaningful.

4) Supporting emotional wellbeing and identity transition

As some people lose weight, they may find that their identity changes along the way. Perhaps they feel more confident and want to embrace this. Maybe they have always been a foodie and now want to adapt their lifestyle to maintain their weight and health. Or perhaps they simply feel different in themselves and are moving on from what previously stopped them from achieving their ‘why’.

There can also be stigma from others around the use of GLP-1 medication, which some people may need support in navigating.

This aspect of taking GLP-1 is often not discussed, but it needs to be considered as part of an overall approach to improving health. It is important to find a non-judgemental and supportive environment in which to discuss and explore these changes. For some people, it may even be the first time they have considered what they want to change about their lives following their experience with GLP-1 medication, and they may need an outlet to explore this.

5) What to think about when stopping GLP-1

For many people, there may come a time when their GP or prescriber discusses reducing the dose or stopping GLP-1 medication altogether. For some, this can cause feelings of uncertainty or concern about regaining some of the weight they have lost.

Weight regain can be common when medication is discontinued, particularly if the lifestyle changes adopted whilst taking the medication are not sustained. It is important to put a plan in place before any reduction or discontinuation of medication begins. This can help people prepare for the change and give them the best possible chance of maintaining their weight and the lifestyle changes they have developed.

It is also important to consider what will happen when weight subsequently fluctuates. Progress is rarely a straight line, and needing additional support is not a personal failure.

The opportunity is to improve the whole treatment experience

GLP-1 medications have created new possibilities for people living with obesity and related health conditions. Their benefits should not be understated, and neither should the importance of access to appropriate medical care.

At the same time, medication alone cannot make everyday decisions easier. It cannot plan a balanced meal, build a strength-training routine, resolve a difficult relationship with food or help someone adapt their habits when life changes.

Ultimately, the goal should not be to help someone lose as much weight as possible, as quickly as possible. It should be to help them achieve meaningful improvements in health and build a sustainable approach to living well.

People will have different ways of addressing these five areas. One option could be to work with a health coach. A well-designed health coaching relationship can provide a non-judgemental space to help people focus on nutrition, strength, everyday habits, wider health and long-term planning, whilst remaining connected to the team prescribing their medication.

Medication can be a powerful part of that journey. The opportunity for health coaching is to help people make the most of it.

The case for working with a Health Coach is not that medication does not work. The clinical evidence for GLP-1 treatments is substantial. Rather, medication and behavioural support have different roles, and people may benefit from having both available as part of a more complete approach to their overall health. As the Functional Medicine Institute describes it, ‘GLP-1 opens the door, and health coaching helps you walk through it.’

What does the research tell us?

Research into GLP-1 medications is still relatively new, and evidence specifically isolating the benefits of working with a Health Coach remains limited. However, there are studies that indicate the potential benefits of combining medication with lifestyle support.

A 2026 study published in the International Journal of Obesity examined 708 adults taking part in NOVI Optimum Plus, a physician-led obesity programme in Singapore combining GLP-1 medication with app-based lifestyle coaching.

Participants achieved an average weight loss of 12.7% after 12 months, rising to 14.7% at 18 months. The study also reported improvements in blood pressure, body fat percentage and HbA1c, a measure of average blood glucose.

Of particular interest, participants who engaged more with the lifestyle coaching app achieved an additional 2.0–2.2 percentage points of weight loss compared with those who engaged less. For someone weighing 100 kg, a difference of 2.0–2.2 percentage points would equate to approximately 2.0–2.2 kg, assuming the comparison is applied to that starting weight.

Whilst the study was observational rather than a randomised controlled trial, it provides a useful real-world example of how medical treatment and ongoing support can be delivered together.

Look beyond weight loss to longer term health

Health coaching cannot guarantee that weight will be maintained after medication withdrawal. However, helping people develop practical skills, confidence and a plan for ongoing care is a reasonable and potentially valuable part of a comprehensive approach.

GLP-1 medication can be an important step towards improving health, but there is more to consider than the number on the scales. By thinking about these five areas, people can look at how they eat, maintain their strength, feel about themselves and build habits that work for them in the longer term. The aim is not simply to lose weight, but to use this opportunity to improve health in a way that can be maintained beyond the scales.

A note on terminology: In this article, GLP-1 medications is used as a broad term for injectable weight-loss medicines targeting single, dual or triple hormone pathways. These medicines should be used under medical supervision, with health coaching complementing, not replacing, clinical care.