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The Drug that Changed the Weight Loss Industry: Semaglutide's Threats and Opportunities for Health Coaches

If there is anything that has been confirmed this year, it’s that anti-obesity drugs are here to stay. Semaglutide (GLP-1 receptor agonists) made incredible shifts to the weight loss industry and have continued to pique interest and raise concern for fitness professionals. 

In a previous blog post, we explained exactly what Semaglutide is, also known by the brand name Ozempic. If you are unfamiliar with this drug, I highly suggest referring to that article first. This drug, originally approved by the FDA in 2017, has been used in the treatment of Type 2 diabetes and to reduce the risk of major cardiovascular events in patients with Type 2 diabetes. Recently, it’s also being researched for its efficacy in reducing addictions such as alcohol and nicotine. 


Our country has stated that there is an obesity epidemic, and as a health coach, I can’t disagree with this statement. I initially wanted to believe that the obesity epidemic could be solved through sound nutrition and training programs – rather than through pharmaceuticals. 


However, as a very experienced (but slightly jaded) health coach, I understand the reality of the accessibility to sound nutrition and training programs for the general population. Another reality is the time needed for individuals to devote to a sound nutrition and training program for the needed lifestyle changes or for those changes to be sustained long enough to reduce their risks. 


While I wanted to be completely against this “miracle weight-loss drug” as a health coach in fear that it made my career obsolete; that would have been exceptionally short sighted. In actuality, there are many opportunities this drug can bring to those who need it as well as to health coaches for clients who are utilizing the drug safely and effectively. 


The Largest Threat 


The fact that this drug works for users without increased physical activity or strength training on the surface would seem like the largest threat. Why would an individual need to hire a specialist if they were going to see weight loss just through drug use alone? 


The individuals who are prescribed this drug do not have to make any changes to their daily expenditure and they will likely lose weight. They can be advised by their prescribing professional to workout, increase cardiovascular activities, etc., but often the user is eating so little and experiencing negative side effects (mainly nausea) of the drug that they physically can’t bring themselves to work out – yet they still lose weight. 


With this large threat also comes the biggest opportunity for fitness professionals with this drug in our space. Weight loss does not equate to only fat loss with the use of this drug. The weight loss that participants have shown in research settings is a combination of body fat and lean body mass. 


The majority of weight loss research (without the use of Semaglutide) shows about a 75% loss in weight from fat mass and a 25% loss from lean mass. The marked difference with Semaglutide in weight loss research is that an astounding 39-40% of loss from lean mass was reported in 2 of the largest studies that looked at the composition losses of participants. ** 


Therefore, within the largest threat also lies the biggest opportunity for fitness professionals and health coaches to truly help those on these weight loss drugs. Anecdotally, we know those on a progressive strength training program while seeking fat loss can retain more (if not ALL) lean mass and show marked improvements compared to the clinical weight loss settings that are strictly low-calorie environments without the use of strength training. We also know that those who have a diet higher in protein and carbohydrates while seeking fat loss see marked retention to lean mass due to an optimal rate of muscle protein synthesis still being achieved. 


These two aspects alone are huge opportunities for fitness professionals and health coaches to place themselves at the forefront of this conversation to help those on these drugs see fat loss as their driving goal, not just weight loss. We also know that sustainable fat loss achieved on this drug is increased when participants employ lifestyle changes that include progressive training and a high protein diet. 


The Overlooked Opportunity  


The last, and potentially overlooked, opportunity with this drug for fitness professionals is that weight loss for some obese individuals can mean that commercial gym equipment is no longer a barrier for them. Their level of confidence to enter into these environments is increased when they can physically fit and use the equipment comfortably. This means that individuals using this drug safely are now stepping foot into a commercial gym setting which can increase the likelihood of them reaching out for further guidance or us getting the opportunity to interact with them and guide them further in their health journey. 


Coaching Strategies with Semaglutide Use 


Recently, the largest obstacles I have overcome as a coach with clients using Semaglutide is the drastic lack of appetite and delayed gastric emptying. We have been able to combat these negative side effects by being more intentional about where in their week we are planning their workouts in relation to their injections or oral medications. When we prioritize protein intake, we can have 1-2 rest days following their Semaglutide use and aim to increase calories in the 48 hours (about 2 days) after administration and assess how they feel to begin their training week following that. On average, this protocol allows clients to get (at minimum) 3 progressive strength training days per week in a supportive calorie environment. 


With continued research being done on these drugs and health and fitness professionals' commitment to understanding the drugs more, we can make a difference in the obesity epidemic and work together for longer, more sustainable results for these individuals. The largest opportunity of contribution we have is for these individuals to NOT have to depend on the drug any longer, garnish sustainable results so that their quality of life and health improve drastically than before the use of a Semaglutide. 


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