by Last updated on September 10, 2026 (originally published on January 10, 2024).
In the evolving landscape of weight management, the emergence of medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of chronic weight management marks a significant shift.
While these drugs have been applauded for their effectiveness in appetite suppression and weight loss, they also bring new considerations for exercise professionals and health coaches. This blog aims to equip you with insights and practical strategies to effectively support your clients who, in collaboration with their physicians, choose these medications for their weight-loss journey.
How Do These Drugs Work?
Different obesity medications work in different ways, including by mimicking gut hormones (GLP-1 and GIP), targeting the gut to decrease fat absorption, activating pathways in the brain to decrease appetite and food intake, increasing caloric expenditure, and reducing blood sugar levels post-eating and slowing stomach emptying. Their efficacy in weight loss has garnered a lot of attention, but it's crucial to understand that weight loss alone doesn't encompass all health benefits.
Emerging Research on the Intersection of Obesity Medications and Physical Activity
In one of the first peer-reviewed articles of its kind, researchers report on how physical activity fits into the treatment of obesity when using obesity medications. This research underscores the need to refocus on lifestyle factors, including physical activity, for those using these medications.
With these medications, traditional goals of exceeding the minimum 150 minutes of moderate-intensity physical activity per week and achieving 200 to –300+ minutes of exercise weekly for substantial weight loss and weight-loss maintenance might be less relevant. That is, meeting the lowest level public health recommendation of 150 minutes of moderate-intensity activity and two days of resistance training per week might be enough to support and maintain weight loss when a person is on an obesity medication. This shift in focus acknowledges the drug’s role in weight loss while also emphasizing the importance of physical activity for overall health. However, because research in this area is still emerging, no specific guidance in this area is available.
Key Takeaways for Exercise Professionals and Health Coaches
Educate About Lean Mass Loss: A growing concern with obesity medications is the rate of lean-mass loss associated with rapid reductions in body weight. It should be noted that any significant loss of body weight is associated with a concomitant loss of lean tissue, regardless of the mechanism (e.g., pharmaceutical and/or lifestyle intervention). Therefore, a comprehensive exercise regimen, with a strong focus on client-centered programming, is essential to improve overall body composition.
Emphasize Muscle Quality Over Quantity: The findings of the research cited above highlight the importance of improving muscle functionality rather than solely increasing muscle mass. Resistance training, which is crucial in this aspect, enhances muscle strength and function without necessarily increasing its size, promoting better insulin and glucose control.
Promote Healthy Eating Habits: While obesity medications aid in appetite suppression, integrating healthy eating habits is crucial. Encourage your clients to focus on nutrient-dense foods that support overall health and complement their weight-loss goals. Balanced diets rich in fruits, vegetables, whole grains, lean proteins and healthy fats can enhance the effectiveness of the medication, improve energy levels for physical activity and support metabolic health. As exercise professionals and health coaches, guide your clients in making informed food choices and developing sustainable eating habits that align with their health objectives.
Explain Potential Side Effects
As an exercise professional or health coach, it is important to be aware of potential side effects caused by obesity medications. While it is not within your scope of practice to determine if your client is experiencing a drug-related side effect, you may be the first person to recognize symptoms shared with you or to observe signs during your sessions. In this case, it would be prudent to make the client aware of the possible connection between what they are experiencing and the drug they are taking and refer them to their prescribing physician. Here is a list of possible side effects of which you should be aware:
- Kidney, pancreas, and stomach problems: Nausea, vomiting, diarrhea, stomach/back pain, constipation, bloating, belching, gas, heartburn and dehydration
- Changes in vision
- Low blood sugar: Dizziness, lightheadedness, anxiety, slurred speech, sweating, irritability or mood changes, confusion, drowsiness, shakiness, weakness, headache, feeling jittery and fast heart rate
- Serious allergic reaction: Swelling of face, lips, tongue or throat; severe rash or itching; and problems breathing or swallowing
- Depression or thoughts of suicide
- Runny nose or sore throat
- Stomach flu
- Decreased appetite
- Gallbladder problems: Fever, yellowing of skin or eyes, and clay-colored stools
- Thyroid problems: Lump or swelling in neck, hoarseness, trouble swallowing and shortness of breath
Stay Within the Scope of Practice: As exercise professionals and health coaches, it's crucial to operate within your scope of practice. This means:
- Providing evidence-based exercise and lifestyle recommendations
- Sharing evidence-based dietary guidelines and resources
- Avoiding medical advice or adjustments to medication regimens
- Collaborating with healthcare providers for a holistic approach to your client’s health
- Collaborating with clients to identify and set goals not related to weight loss
The Future of Exercise in the Era of Obesity Medications
Research in this area is still emerging, and updated perspectives may evolve as new studies emerge. It is important to keep up on the latest research and be flexible in adapting your coaching and training strategies accordingly. Rest assured that these medications do not negate the need for lifestyle change or lessen the importance of the work you do with your clients. Your role in guiding clients through their weight-loss journey, especially those using obesity medications, is as invaluable as ever. And, remind clients that weight loss alone is not a replacement for movement and that there are countless reasons and benefits associated with physical activity and exercise beyond weight loss, including heart health, mobility, strength and emotional well-being.
Conclusion
The ubiquity of obesity medications has reshaped the weight-loss landscape, requiring a nuanced approach from exercise professionals and health coaches. By focusing on improving muscle quality, adapting exercise recommendations and understanding the implications of the loss of lean mass, you can play a pivotal role in your clients' health and well-being. Stay informed, collaborate with healthcare professionals, and continue to inspire your clients toward healthier, more active lives.
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If you’re interested in gaining the knowledge and practical strategies to confidently support clients who are using obesity medications, be sure to check out Coaching Clients on Obesity Medications (worth 0.5 ACE CECs). Upon completion of this course, you’ll be able to apply evidence-based behavior-change strategies to improve client engagement and long-term success. You’ll also learn how to collaborate effectively with healthcare providers while staying within your professional scope of practice. |
