The conversation no one’s really having

As a non-medical weight loss coach, you won’t hear me demonise weight loss injections.
There are situations where GLP-1 medications like Ozempic, Wegovy or Mounjaro are absolutely appropriate, especially when medically supervised and used as part of a broader, long-term health strategy. Some of my clients are on them (not prescribed by me – I’m not a prescriber) and I’m so proud to say that they’re doing really well. Significant weight lost, and along with it, improved mental and physical wellbeing and more fulfilling lives. 

But the truth is, while there are reputable providers following the requirements, many people aren’t getting a long-term health strategy. They’re simply getting the injections, and this really concerns me, as a weight loss coach with people’s health at the heart of what I do.

With some providers, it starts with a quick online form to complete.
A few informational pages about the risks, that they’re not required to read, only tick a box to say they’ve read it, (thus passing the risk on to the customer.) But who actually does read all the small print?

Then, if they’ve met the criteria, they’re at checkout and able to purchase.

No actual conversation at this point. No verification of the information provided at this point. 

There might be no comprehensive 1:1 assessment.

With no one asking detailed information about your relationship with food, mental health history, body image, or past diet patterns.

Just boxes to select or tick yes/no. 

Just fast-track access to a powerful drug, and little clarity on what happens after. Thankfully measures are being put in place to tighten things up, but it’s slow to change.

That’s why I’m writing this.

Because while the headlines keep selling us “life-changing,” “game-changing,” “finally something that works”, and no doubt huge health benefits from lost weight, what’s also emerging is the ripple effect of what gets lost along the way, and how important it is to safeguard people’s health, not make it worse.

Just because you CAN get weight loss injections, does it mean you SHOULD? And if you do, you STILL need to do the work.

The side effects being revealed

I’m not talking about a bit of nausea or constipation.
I’m talking about the deeper, longer-term consequences that some people are starting to experience, often without being prepared for them:

• Muscle loss
• Weakened bones 
• Pelvic floor weakening
• Tooth and gum issues from vomiting or dry mouth
• Malnutrition
• Digestive disruption, and pancreatitis 
• Rebound weight gain when injections stop
• Mental health concerns

This isn’t scare-mongering.
It’s informed consent. As a weight loss coach, I strongly believe you need to know the risks as well as the benefits when making a decision about what’s right for you, and whether the benefits outweigh the risks or not. 

Because when you lose weight fast, especially through appetite suppression, your body doesn’t just lose fat.

It loses critical lean tissue… your muscle, your strength, your energy reserves.

And with less muscle?

Your bones stop getting the physical stress they need to stay dense.
This is how people become physically lighter, but structurally weaker.

Your ability to burn calories is reduced, meaning weight regain is more likely.

It’s a hidden cost that most of the marketing doesn’t mention.

You’re not failing. The system is. 

The truth is these medications manage your hunger. BUT…
They don’t teach you how to manage your thoughts, your nervous system, or your choices.
They don’t teach you how to feel safe in your hunger.
They don’t repair your trust with yourself around food.

They’re a crutch, but no one is teaching you how to walk when it’s taken away. As human we naturally like to do things in the quickest and most efficient ways. But at what long term cost? 

You still need to effectively manage your diet to make sure it’s nutritious so you can become or stay healthy for the long term.

You still need to make the time and effort to do exercise, including resistance training, to preserve your muscle mass and bone density.

Appetite regulation is a skill, not just a symptom to suppress

Here’s what the headlines often leave out:
GLP-1 injections may help with weight loss.
But they do not rebuild your belief in your ability to maintain it.
They don’t teach you how to navigate emotional eating, how to slow down around food, how to respond (not react) when life gets stressful.

Even the NICE guidelines recommend working with a weight loss coach or nutritionist during treatment, but from what I’ve seen, that’s rarely explained or prioritised by providers.

Weight loss coaching is often optional, inconsistent, or offered as a generic add-on.

But if you have a long history of weight problems, you need more than a food tracker and “check-in.”
You need someone who sees the real complexity behind your eating patterns.
Someone who helps you decode the signals beneath the urge to overeat.
Someone who can help you rebuild your internal regulation, not just external restriction.

You may say that you’ve ‘tried everything’ prior to weight loss injections, but have you tried working in-depth, on a 1:1 basis, with a weight loss coach, as opposed to a weekly diet club or a personal trainer?

What weight loss actually looks like when things start to shift

This week, one of my ongoing 1:1 clients, someone who’s had decades of yo-yo dieting and food confusion (including from trying ‘everything’ before, said to me:

“I’m starting to gain confidence in my thoughts and behaviour, with more belief I can navigate situations I used to find very difficult.”

She’s heading away for a family birthday.
In the past? That would have been a minefield.
Now?

She’s not spiralling.
She’s not panicking about food.
She knows how to make choices that are in support of her goals while away, and to course-correct afterwards, calmly, without shame.
She trusts herself.

That didn’t come from injections.
That came from doing the real mindset work.

Another client recently shared:

“It’s been a really busy, stressful, emotional week. The good news is my weight has remained stable. That wouldn’t have been the case before. I would have gained.  My routines haven’t been perfect,  but I’ve still managed.”

This is what sustainable weight management actually looks like.
Not perfection.
Not control.
But capacity.

Before you make your decision whether to use weight loss injections, ask what you really need

If you’re already on injections, that doesn’t mean you’ve failed.
It means you get to ask:
What do I need to do to make sure I safeguard my results?

And if you’re considering them, I invite you to pause.
Not because you shouldn’t take them.
But because you deserve a proper conversation and a proper assessment before going ahead.

Because maybe it’s not your appetite that needs fixing.
Maybe it’s your confidence.
Your clarity.
Your belief that you can trust yourself again.

And those things?
They don’t live in a prescription.
They live in relationship.
With food. With your body. With yourself.