Why GLP-1 Medications Aren’t Enough — And What Your Patients Need

By Cathy Sykora, Public Health Education and Communication

GLP-1 receptor agonists, such as semaglutide (Ozempic, Wegovy), have revolutionized the treatment of obesity. Their ability to induce 15%–21% total body weight loss, along with improvements in insulin sensitivity, cardiovascular markers, and inflammation, has made them an essential tool in clinical practice.

But as more providers prescribe these medications, an uncomfortable truth is surfacing:

GLP-1s are powerful. But they’re not complete.

Without structured support, many patients face preventable complications — and missed opportunities for lasting success.

In this post, we’ll cover:

• The five most common clinical pitfalls of GLP-1 therapy

• What the latest research (including JAMA Internal Medicine) recommends

• And how programs like Metabolic Reset can fill the gap between prescription and outcome

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1. Tracking Weight ≠ Tracking Success

GLP-1s drive impressive weight reduction. However, scale weight alone doesn’t capture clinical success—or risk.

Physicians are encouraged to:

• Track weight monthly during dose titration

• Evaluate muscle mass, energy, mood, and signs of malnutrition

• Intervene if weight loss is <5% after 12–16 weeks or >20% with red flags (BMI <18.5, calorie intake <800 kcal/day, amenorrhea, reduced libido)

What your patients need: Structured assessments, education on meaningful metrics, and clear follow-up guidelines. Metabolic Reset offers this, so you don’t have to build it from scratch.

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2. Up to 40% of GLP-1 Weight Loss Comes from Muscle

This is one of the most under-addressed consequences of rapid weight loss on GLP‑1s — especially among older adults.

Clinical recommendations include:

• 1.0–1.5 g of protein per kg of body weight daily (even higher for older adults or post-bariatric patients)

• Strength training 2–3 times per week

• Protein supplementation when appetite is suppressed

What your patients need: A sustainable nutrition and fitness plan. Metabolic Reset includes step-by-step protocols that protect lean muscle mass while supporting the effectiveness of medication.

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3. Micronutrient Deficiencies Are Easy to Miss — Until They’re Not

Most patients with obesity already have low levels of:

• Vitamin D

• Vitamin B12

• Iron

• Magnesium

• Folate

• Zinc

GLP-1s reduce appetite and slow gastric emptying, which can exacerbate these deficits.

Clinical best practices:

• Lab screening before or during treatment

• Registered dietitian or coach referral

• Targeted supplementation based on real data

What your patients need: More than calorie tracking — they need nutrient-dense meal guidance and screening tools. Metabolic Reset provides both.

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4. Side Effects Are a Top Driver of Dropout

GLP-1 medications frequently cause nausea, constipation, reflux, and bloating — especially early on or during dose escalations.

These symptoms are often manageable when patients are educated and prepared:

• Small, low-fat meals

• Avoiding fried or spicy foods

• Ginger, hydration, fiber, and upright positioning

• Short-term use of osmotic laxatives when appropriate

What your patients need: A playbook they can follow. Our program provides coaching tools to help manage GI side effects without panic or discontinuation.

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5. What Happens When They Stop the Medication?

This is the elephant in the room.

In most clinical trials, patients regained 7–12% of their lost weight within one year of discontinuing GLP‑1s. And yet, many receive no guidance on what to do when they stop — or mistakenly assume the effects will last without intervention.

Physicians should:

• Set long-term expectations up front

• Create structured off-ramping protocols

• Monitor for relapse and reintervene early

What your patients need: A durable lifestyle framework they can maintain before, during, and after the prescription ends. That’s what Metabolic Reset is built for.

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Metabolic Reset: The Clinical Partner You Didn’t Know You Needed

We created Metabolic Reset to give practitioners a reliable, ready-to-deploy solution that:

• Reduces dropout and side effects

• Preserves lean muscle and metabolic health

• Provides food, fitness, and supplement structure

• Supports patients every week for 6 months

• Makes your GLP-1 treatment plan work long-term

If you’re prescribing GLP-1s, you already know the benefits. Now let’s lock in the outcomes.

License Ready-to-Brand Metabolic Reset for your practice now.  SAVE NOW

Would you like to refer patients or partner with us?
Book a 15-minute strategy session to learn how Metabolic Reset can be integrated into your practice.

About the Author

Cathy Sykora is a certified health coach and the founder of a portfolio of evidence-based, physician-endorsed, and professionally branded health programs designed to help practitioners deliver structured, lifestyle-focused interventions within both clinical and coaching environments. Her work bridges the gap between medical treatment and long-term behavior change, equipping health professionals with scalable tools grounded in science, education, and patient engagement.

Cathy brings a rich and diverse academic background, combining training in public health, integrative nutrition, natural healing, and business leadership. Her educational and professional development includes:

• Johns Hopkins Bloomberg School of Public Health – Public Health and Scientific Research Methodologies

• University of Virginia / Darden School of Business – Business Strategy for Health Innovation

• The Institute for Integrative Nutrition – Holistic Nutrition and Lifestyle Medicine

• Trinity School of Natural Health – Natural Health Modalities and Wellness Coaching

• Body Mind Institute / David Wolfe’s Raw Nutrition Certification – Raw Food Nutrition and Applied Healing Practices

• Hippocrates Health Series – Bridging Traditional Healing with Modern Science

• The Art Institute of Pittsburgh – Design Communication with a Purpose-Driven Focus

She is a member of the American Association of Drugless Practitioners (AADP) and a frequent contributor to practitioner-focused education through The Health Coach Group (www.thehealthcoachgroup.com).

Inner Circle (Includes BA, OMM)

Platinum Business Packages

Done-for-you programs

The Metabolic Reset

Resources and Further Reading

Clinical Guidelines & Research

Jastreboff AM, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine. 2022;387(3):211–222.

Rubino DM, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Regain. JAMA. 2021;325(14):1414–1425.

Aronne LJ, et al. Addressing the Muscle-Loss Risks of Weight Loss Medications. Obesity Journal. 2023;31(2):191–198.

Ryan DH, et al. Management of Obesity with GLP-1 Receptor Agonists. JAMA Internal Medicine. 2023.

Apovian CM, et al. Guidelines for the Management of Overweight and Obesity in Adults. Endocrine Practice. 2015;21(Suppl 1):1–203.

Patient-Focused Resources
6. Rapid Eating Assessment for Participants – Shortened Version (REAP-S): Screening tool for dietary quality, available at https://www.researchgate.net/publication/272528097
7. CDC Adult BMI Calculator: https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html
8. ChooseMyPlate.gov – Nutrient-density and meal planning resource.

Lifestyle Medicine Integration
9. The Health Coach Group – Metabolic Reset Program: Structured patient support designed for GLP-1 users. https://www.thehealthcoachgroup.com/metabolic-reset-2/
10. American College of Lifestyle Medicine (ACLM): https://lifestylemedicine.org
11. Academy of Nutrition and Dietetics – Evidence-Based Practice Guidelines: https://www.eatrightpro.org/practice

Micronutrient & Muscle Health
12. Cegielski JP, et al. Nutrient Deficiencies in Obesity and After Weight Loss. Nutrition Reviews. 2020;78(3):214–230.
13. Fielding RA, et al. Sarcopenia: Muscle Loss and Functional Decline in Aging. Journal of the American Medical Directors Association. 2011;12(4):249–256.