Weight Loss Drugs: A Coach's Perspective

Wegovy, Ozempic, Rybelsus—these are the buzzworthy names we’ve been hearing about in the world of weight loss. These medications, known as semaglutides, are the “weight loss shots” everyone seems to be talking about.

Let me start by saying this: the purpose of this article is not to shame anyone who is currently taking, has taken, or is considering taking a weight loss drug. In fact, it’s the opposite. I want this platform to be a safe space where people feel open, heard, and encouraged to ask questions and learn. While I may not agree with many of the prescribing practices around these medications, I absolutely understand why people turn to them.

Weight loss is hard—really hard. Especially in a culture that makes it feel nearly impossible.

If you’ve thought, I just want to feel better, I just want to lose the weight… could this be the answer?—you’re not alone. So, if you’ve taken these medications, are currently taking them, or are thinking about it, I hope you’ll keep reading.

Also, a quick disclaimer: I am not a physician or a registered dietitian. I am a certified nutrition coach with years of experience working with real people and a passion for helping them live their best lives. I believe in empowering people to make informed decisions about their health. Unfortunately, we can’t always rely on regulatory agencies to protect us or point us in the right direction. That’s a stance I feel strongly about, and it’s why I’m here to share what I know.

In this article, I will cover what these drugs are, how they work, the risks and benefits as I see them, and what anyone taking—or considering taking—these medications should know and implement alongside their use.

What Is GLP-1?

To understand how these drugs work, we need to talk about GLP-1.

In the body, GLP-1 (glucagon-like peptide-1) is a naturally occurring hormone that plays a key role in regulating blood sugar and appetite. It’s released in the gut after eating and has a few critical jobs:

1. It stimulates insulin release from the pancreas, helping to lower blood sugar.
2. It slows down how quickly food leaves the stomach, keeping you full longer.
3. It sends signals to the brain to reduce appetite.

This multitasking hormone helps balance energy intake and glucose levels, which is why it’s a focus for both diabetes and weight management treatments.

So, why is this important? Because these semaglutide medications—what people call “weight loss shots”—are GLP-1 receptor agonists. That means they mimic or act like the GLP-1 hormone to help control blood sugar, reduce appetite, and promote feelings of fullness.

Originally developed to treat diabetes, these medications require higher doses when used for weight loss to maximize appetite suppression.

So, What’s the Catch?

If you’re still with me, you might be thinking, This sounds great—so what’s the problem? Let’s break it down.

First, I want to acknowledge the potential benefits of these medications, especially for individuals struggling with extreme obesity and related health issues. For some people, the risks of these conditions outweigh the risks of the drug, making weight loss the primary goal. In those cases, I support their use—but with some important caveats.

I strongly believe these medications should always be prescribed alongside support from a nutrition coach, educational program, or dietitian. Why? Because if we don’t change habits, we won’t sustain progress. Let’s dig into my concerns:

My Concerns with Weight Loss Shots

1. Hunger Cues Are Natural
   Hunger isn’t the problem. It’s a natural signal from your body that you need energy. The issue for most people isn’t “overactive” hunger cues—it’s the stress, busyness, and abundance of calorie-dense, nutrient-poor foods in our environment. These drugs don’t address those habits. They’re a band-aid, or worse, a crutch that can lead to poor-quality diets consisting of too few, low-nutrient foods.

2. Your Body Needs Food
   Let me say that a little louder for the people in the back. YOUR BODY NEEDS FOOD. Many users on these drugs struggle to eat enough to meet even basic energy needs. Yes, eating 900 calories a day can lead to weight loss—but it’s unsustainable and unhealthy for your hormones and organs. Over time, your amazing, adaptive body lowers its metabolic rate to conserve energy, to protect you. This makes maintaining weight loss incredibly frustrating later on, trust me.

3. Muscle Loss
   Rapid weight loss often leads to significant muscle loss. Muscle is essential for a healthy metabolism and aging. Muscle is king. And, If you’re losing muscle at the same rate as fat, are you really improving your body composition?

4. No Exit Plan
   These medications are often intended for long-term use, but that’s not always clear to patients. I’ve had clients whose physicians had no plan for tapering off the drug, leaving them without tools to sustain their results.

5. Unknown Long-Term Effects
   While there’s long-term research on these drugs for diabetes, there isn’t for their use in higher doses for weight loss. Also, GLP-1 affects more than just the gut—it also influences the brain, liver, kidneys, pancreas, and heart. What are these drugs doing to those systems long-term? We don’t know yet.

What Should You Do?

If you’re already taking these medications:

• Focus on developing sustainable habits that will help you maintain your progress without the drug, while you are on the drug.
• Learn how to eat in a calorie and macronutrient range that supports your maintenance.
• Address emotional or environmental triggers that lead to overeating.
• Improve your relationship with food, learning what to eat, how much, and how to prepare it.
• Build consistency, even when life gets hard.

Consider working with a coach or joining a program while on the medication to set yourself up for long-term success.

If you’re not taking these medications yet:

• Focus on building these habits first. If you still feel the drug is necessary, you’ll already have a strong foundation to sustain your progress.
• Think of it as an investment in yourself. The money you’d spend on the medication could instead go toward a coach or program to help you achieve results naturally.

Wrapping It Up

If you’ve made it this far, thank you for reading. I know how frustrating it can feel to navigate weight loss on your own. But as someone who’s had the privilege of supporting so many amazing health journeys, I know it can be done—and you can do it too.

I offer tools and coaching programs to help support your journey. Kickstart your lifestyle changes with my free Beginners Macro Guide + Recipes.

If you have questions, feel free to reach out—I’d love to help however I can.

Best Wishes,
Coach Ashleigh