How do I coach a client through weight gain after stopping GLP-1?

Start by normalizing the regain before you address anything else. The majority of people who take a GLP-1 for intentional weight loss eventually stop the medication, and when they do, the weight returns, often quickly. This mirrors what happens after any form of intentional dieting. Naming this as expected and biological, rather than as a personal failure, is the first move in the session.

Do not respond to a client’s panic by trying to reassure or fix the emotion. Meet panic with curiosity instead. Ask what she is afraid of losing if the weight stays, and what she believes will happen if she cannot get it back off. These questions surface the belief system driving the panic, which is usually more about safety and self-worth than about the number on the scale.

If you coach from a thin body, name that directly with the client. Acknowledging thin privilege, without turning the moment into a discussion about you, builds trust and prevents the conversation from becoming inadvertently dismissive of her experience.

Once the panic has been acknowledged and neutralized, help the client play out her proposed solution, whether that is another diet or going back on GLP-1, to its likely outcome. This reality test, combined with consent to explore an alternative, opens the door to body image and body acceptance work. Solving weight gain does not require weight loss. It requires a different relationship to the body.

Transcript

[00:00:03] Stephanie: Welcome to It’s Beyond the Food podcast, my sister. My name is Stephanie Dodier.

[00:00:07] I’m your host, and today we’re gonna talk about how to coach weight gain, even more specifically in the GLP-1 era, and how we need to think about this and how we can meet our client in this experience that is most likely to happen

[00:00:27] If you are new to this podcast, you may not know this, but we had a series of episode in the month of May and June, and almost part of July as well, 2026, called Beyond GLP-1 Series, and this podcast episode today is coming from there. Uh, I interviewed nine expert physician, MD, researcher, PhDs, very smart people, and deep dived into nine different angle of the GLP-1 era and how we can think about our client, the work we’re doing with them in a weight-neutral lens while the GLP-1 era is unfolding.

[00:01:15] So if you haven’t listened to this, uh, maybe something to put on your listen list. One of the thing that we’ve learned through this expert series as of August 2026, is that a vast majority of people will drop off of using GLP-1. The rate by which there is a drop-off varies per study, but it’s anywhere from 50% to 75% of people who start a GLP-1 will end up stopping the medication for various number of reason, from side effect, financial, to weight regain or not losing the weight because some people who take a GLP-1 don’t lose the weight, and there’s a whole other variety of reason.

[00:02:03] And it– when you listen to those podcast episode, you’ll hear some of the specific around this. But bottom line, we do know that people stop taking GLP-1, and what we also know is that when people take a GLP-1 with a purpose of intentional weight loss, when they stop the medication, the weight comes back, and it comes back very quickly.

[00:02:29] So that’s where this episode comes from. So how do we as coaches, practitioner, how do we help people who are experiencing that weight gain? And although I’m gonna talk a lot about GLP-1, it is also for anyone gaining weight because one thing that became clear for me as I did those 10 to 12 hours of listening to expert with my own expertise in the non-diet approach, what they were describing to me was the experience of regaining the weight after any diet.

[00:03:13] Like the outcome of GLP-1 were the same as a cla- we’ll call it a classic dieting. And for those who don’t know, I have a… I like to say to people that I have a PhD in dieting. I am a, um, nutritionist with her own 25 years of lived experience of dieting, of all the diets in the world, literally all of them, um, starting at 12 years old, and my last one was at 38 years old.

[00:03:49] So for this whole span of my life, I pursued the thin ideal in all the ways that were available, from the low fat in the ’80s to keto, intermittent fasting, bodybuilding, the whole thing. I’ve done them all. And what I was hearing from these expert and myself reading the science is, is the same thing I experienced trying to lose weight my whole life.

[00:04:18] So as a professional in this field, helping, counseling, coaching people through the experience of weight gain is part of what we do. So that’s why I thought I would put this episode into the world and guiding you through my thoughts, kind of my beliefs about weight gain, sharing that with you first, and then the second part of the episode will be, um, kind of how I approach a client, what is the steps that I go through when a client is going through the experience and they’re panicked about gaining weight.

[00:04:59] So let’s start with the six, um, consideration reframe philosophy that I like to think about when I think about weight gain.

[00:05:13] The first thing, and these are the things that I talk with my client about. By the way, it’s not just the things in my head. That’s… I, I’m a practitioner of cognitive behavior coaching, so it’s all about coaching the thoughts and sharing thoughts, right? This, uh, it’s a very, um, intense, talkative experience, cognitive behavior coaching.

[00:05:34] So these six reframe, I’m gonna drop in at some place in the conversation with my client. So the first one, when people are coming to me with the experience of weight regain, my foundation is nothing has gone wrong. Like, in my head, I’m meeting them with, oh, okay. Like, it’s… it was expected. Like, I’m not saying that to them because that would be extremely confronting for me to say that to them.

[00:06:02] But in my head, I’m like, okay, nothing has gone wrong. It’s expected that you regain the weight after a diet. It’s expected that you regain the weight after a GLP-1, so I’m not meeting them with, oh my God, there’s a problem and I need to fix it. Like, the weight regain is not a problem. Now- Before I get to talk to that with the person who’s panicked about her weight regain, that may take a few sessions, that may take 30 minutes, 40 minutes before we get there.

[00:06:39] But I’m approaching from the perspective of nothing has gone wrong. If they were doing a, quote-unquote, “classic dieting,” it’s normal to regain the weight. There’s a whole set point theory behind that. It’s, it’s known, and it’s also known in GLP-1. So it was expected to regain the weight, but for whatever reason, this person that’s in front of me right now wasn’t aware of this, or they were expecting to be the outlier, to be different.

[00:07:12] Which by the way, is what we’re seeing a lot right now. We’re seeing a lot of people that are coming… When we- I say we, I’m talking about me, I’m talking about the people that I train, my mentee, the people I supervise. We have the rebound area of GLP-1 that are starting to come where people thought, “I’ll go on a GLP-1, I’ll change my health-promoting habit.

[00:07:37] I’ll come off of this, and I won’t regain the weight. I’ll be the exception to the rule. I’ll be the outlier to the statistic.” But it’s not what happened. They still regained the weight. So they’re panicked because their belief system was they weren’t gonna regain the weight, and their body is doing something wrong.

[00:08:01] They’re doing something wrong, and they’re causing themself a large amount of suffering, of torture by thinking they did something wrong, their body did something wrong, otherwise you would have not regained the weight. So that’s the first thing. That’s how I’m, I’m the recipient, that’s how I’m approaching it.

[00:08:26] The other foundation of coaching weight regain is right away when, when someone is panicked about regaining weight, in my mind, I know there’s a relationship to their body belief system challenge there. Because if they are in a place where they’re panicked at regaining the weight, it’s because somewhere, somehow, in their belief system, they’re thinking they should have been able to control their weight, they should have been able to control their body.

[00:09:01] So they have a relationship to their body that’s very transactional Right? They’re, they’re not in their body as a partner, as an ally, as a respectful relationship. They are in a, we call that in the body image roadmap, like a body hate relationship, a very transactional my body should be doing something for me, and if I play with a different lever, my body will lose the weight.

[00:09:32] And that’s part of my journey with coaching them, is coaching them to change their relationship to their body. The third, um, kind of guiding principle is Understanding why the fear is there in the first place, right? What do they think… Beyond the fact that they know that they did something wrong, their body did something wrong, what is the other thing they fear will happen?

[00:10:06] And that comes through of, uh, uh, um, either an intense coaching session or an intense intake session, what I call, like, the, the left side of the river and the right side of the river, right? They had a problem, and they wanted to go on the other side. Like imagine you’re in the forest, you have a river in front of you, and then there’s the other side of the river, right?

[00:10:31] And the… There’s a bridge to cross the path so you can keep hiking, and their bridge to go, to go towards what they wanted was GLP-1. So originally I’m thinking, okay, they, they had a problem, I have to figure out what it is, that they thought was gonna be solved by GLP-1, and then they were gonna get this beautiful other side of the river: happiness, health, comfort, whatever.

[00:11:00] My job is to figure out what they’re afraid they’re not going to have because they’re regaining the weight. So through coaching question, open-ended question, I’ll give you some of that in just a moment, try to discover that with them. The other angle I want you to think about is it’s most likely if they come to you for support, that they grasp the concept of body acceptance, and they refused it, hence why they went on the journey of intentional weight loss.

[00:11:36] The other thing I’m just realizing as I’m teaching you this, there’s two use of GLP-1 if you want. Um, there’s a small group of people that take GLP-1 from a, like, a pathology medical condition like type 2 diabetes, right? Which is exactly why GLP was discovered, by the way, was for type 2 diabetes, and then they realized over the years that if they increase the dose, people lose weight.

[00:12:04] So what’s happening now is we have a group of people, which is small, using GLP-1 at low dose for insulin mechanism, type 2 diabetes management, which we’re seeing a lot of PCOS folks also going there. But they’re not taking that to lose weight Now, unfortunately, that’s the smallest group of people on low dose.

[00:12:28] The vast majority of people are taking larger doses to induce weight loss, so that’s the group I’m talking about here. That group of people probably went to GLP-1 because they didn’t wanna accept their body as it was, and usually under that, they have a perception that body acceptance mean giving up. So they are thinking, “If I’m accepting my body as is, that mean I’m not gonna get the what I want on the right side of the river.

[00:13:00] That mean I’m gonna give up, I’m gonna be lazy, I’m gonna be unhealthy, I’m not gonna work on myself,” because the only way they know how to work towards feeling better and healthier is through weight loss, right? They’re very weight-centric because of the society we live in. They don’t understand that there’s a weight neutral approach to health, that you can do a whole bunch of things to feel better and take care of yourself, take care of your health without being focused on weight loss.

[00:13:29] So they don’t understand that. So very often we have to do a lot of teaching and mindset work around body acceptance. Which leads me to the other point, usually when people are panic with weight gain is because they don’t understand there’s another way of getting what they want in their life, right?

[00:13:51] Remember the right side of the river? Um, they don’t understand that there’s another way I can help them feel confident, feel comfortable, feel better, be more condition, if that’s what they’re seeking, have less pain without ever pursuing weight loss. They don’t comprehend that because they’ve never worked with me before.

[00:14:15] They don’t understand the notion of weight neutral approach to health or they have misunderstanding about it. So part of my conversation with them will be to introduce them to a weight neutral approach to help and help them change their mindset, their thinking pattern around that The other big piece when we see people panic about weight gain, it’s most likely that they have a very disordered relationship to food.

[00:14:45] Because even with GLP-1 or a, what I call a, quote, “classic intentional weight loss,” people eat less to lose weight. So again, not only do they have a transactional relationship to their overall body, they have a transactional relationship to food. Food for them means weight gain, weight loss. Food for them means good or bad, right?

[00:15:12] The whole foundation of intuitive eating is disordered there, and they certainly cannot trust their body to tell them what to eat, right? And it’s why they’re using a GLP-1 which numbs out their hunger, fullness, and satisfaction cue so that they can eat less and control their body. So that’s another thing that we can pretty go into the conversation with the person with that.

[00:15:40] And the last element I want you to put on your radar is the notion of internal safety and self-compassion When people are panicked, they’re fearing weight gain, they have weight gain, and they’re, like, panicking, it is most likely that they don’t feel safe in the body that they’re heading towards. Like, they’re afraid of gaining the weight because they can’t say that, but I’m just saying as a clinician, I’ll tell you, it’s safety.

[00:16:13] They think it’s about comfort and confidence, but it’s really about internal safety. They don’t have a skill set to create internal safety, and they don’t have a relationship to themself of compassion. Because when, when you unboard compassion and self-compassion, it’s going to be very difficult as a person who have respect for their body and self-compassion to go and take action to starve your body, to inject yourself with medicine to lose the weight, and to affect metabolism.

[00:16:54] Like, it’s just, it’s not one plus one, it doesn’t equal two. So part of the mechanism of solution will be to help and teach them how to create safety in their body, no matter what size it’s at, and also develop a relationship to their body of allyship, partnership, respect, and self-compassion. And the panic…

[00:17:22] So if a, uh, so if a client comes to you, and that can also happen in session, right? Let’s say client is not even involved with GLP-1, they’re doing the work with you from a non-diet approach and doing intuitive eating, and they’re gaining weight, and then they come to a session, “Oh my God, I stepped on the scale and I’ve gained weight.

[00:17:43] Oh my God, I put a pair of pants, I can’t buckle them anymore.” And they have this, like… It’s like almost they’re gonna die. I’m s- If you’ve been working with people around food, and women, and body, you’ve had those people, or maybe you’re one of them.

[00:18:03] “Oh my God, I’m gaining weight,” right? When people are that dysregulated about gaining weight, there’s also probably A lack of emotional intelligence. What, what I mean by emotional intelligence, for me, emotional intelligence is the ability to relate to your emotion with intelligence, to understand what an emotion is, why an emotion happened, and how to regulate your emotion.

[00:18:36] So when that sense of despair and panic is there, there’s most likely a lack of emotional intelligence, which is perfect. That’s gonna be part of the thing you’re gonna work with people on. So these are the consideration for you to go into any conversation with somebody who’s gaining weight. Now, what does it look like in practice?

[00:19:03] So this is gonna be more of a coaching process type of conversation. So imagine that a client shows up either in a consultation, in a Zoom room, on a session, and they arrive with that, oh my God, despair, disgust, panic. “I’m gaining weight and I wanna quit. Oh my God, I’m gaining weight and I want help.” Right?

[00:19:24] That, ugh, like you can feel their whole body, ugh, tense. The first thing for you as a professional t- is never to act as a reassurer or a fixer of emotion. That’s not your role. Your role is… The last thing you wanna say is, “Oh my God, it’s gonna be all right. Don’t worry, we’re gonna, we’re gonna help you with that.”

[00:19:51] That, that is not the way we do things, right? So if that’s your reaction, you need to come and work with me inside the non-diet coaching certification, and I need to teach you some coaching skills. So that panic is not met with, “I’m gonna fix it.” That panic is met with, “Tell me more.” You want the person to unpack, to tell you more about why they feel panicked, and your question Is going to be trying to find what’s on the right side of the river.

[00:20:27] What are they afraid of losing? What are they afraid of not getting to? What are they afraid is gonna be taken away from them? What’s gonna happen to them? You wanna ask them question so you can understand their fear, their panic, their disgust, their despair better. So acknowledging and then asking question.

[00:20:53] Once you’ve g- got an idea of why they’re so panic, then you wanna think about neutralizing the weight gain in itself, right? By normalizing. Okay, now I understand better. The first thing I wanna tell you is, given your circumstance, whatever, they’re on a diet, GLP-1, given the circumstance, that weight regain is normal.

[00:21:21] It’s expected. It’s a biological process. It doesn’t mean anything about you. It was expected. And then go into the reason why that is and explain it to them, if it’s GLP-1, if it’s a classic process of intentional weight loss. Unload the burden in their mind that they did something wrong. Okay?

[00:21:49] And by then normalize the intensity of the emotion that they’re experiencing. And I’m gonna pause here and I’m gonna talk about thin privilege, okay? ‘Cause vast majority of the practitioner coaches listening to this exist in a thin body, in what society consider to be a normal body size. Okay? And, and by that I don’t mean that people in larger body are not normal, I’m just saying through the eyes of society, they’re considered, quote, “a normal body size.”

[00:22:31] And you have a person in a larger body in front of you, you wanna be really careful. You wanna acknowledge your thin privilege and say something like, “I can only imagine what it feels for you. I can’t put myself in the shoes, but I can only imagine how intense the fear, the panic is right now. It makes total sense for you to be afraid to gain more weight or to go back to the weight you were before,” whatever the circumstance is, and acknowledge that given the presentation of your body, you can’t fully comprehend them.

[00:23:12] Acknowledging your thin privilege here is essential in the conversation. And this, this is probably somewhere where I’ll see a person like me who exists in a larger body has probably a easier time having those conversation because when people come to me panic, I’m like, “Yeah, I get it. I, I totally understand where you’re coming from.

[00:23:38] Been there, done that. I hear you.” Like, they understand that I understand their suffering. So given your particular circumstance, you wanna name the thin privilege or you wanna use your own experience, of weight regain to help them de-intensify their experience And then keep asking question, right? Keep asking question about now that you’ve normalized it, now that you’ve, like, de-centered them as the problem why they’re gaining weight, tell me more.

[00:24:15] What do you think’s gonna happen if you gained the weight? What are you thinking about people that exist in the body that you’re afraid of being into? What are you thinking about? How does that make you feel? You wanna unhurt as much of their belief system that creates the panic. This is where a model of coaching like cognitive behavior coaching is so helpful because through powerful question, you’ll be able to really unpack that.

[00:24:42] Then drop into the body We cannot coach weight gain by just staying in the mind because the, the despair, the panic, the disgust is not experienced in the mind, it’s experienced in the body. So whenever you’re with a client who the experience of weight gain is that intense, make sure that you’re going into the body with them, whatever your methodology is, and helping them feel their body, helping them name the emotion, label the emotion, label the sensation into the body.

[00:25:23] For me, I use a system called Riding the Wave, and, uh, I’m not gonna walk you through this, but it’s a emotional process to help them feel their emotion. And what happens when you drop into the body, into the despair, the panic, the shame, the intensity of the emotion goes down another level. Because as soon as the body perceives that the mind has acknowledged they’re having…

[00:25:52] Like, the nervous system is having an experience in the moment, and the brain is in the experience, right? The nervous system starts creating some safety, and for most people, it helps come back to baseline or to regulation states. So feeling the emotion, naming the emotion, labeling the sensation, it’s a somatic process you need to help them go into the body.

[00:26:24] And then ask them, okay, so now that they’re… They’ve been in the body, they’ve been in the mind, you’ve named the fear, then bring them back to, okay, now. Now what? What are you gonna do? What’s the next step here? And what I call, I call it, quote, “playing the worst-case scenario.” Right? Help them name what they’re seeing as the solution to this problem of weight gain.

[00:26:57] ‘Cause it’s really important you go there with your client because there’s not a million solution, right? So we have been trained as women when we gain weight, we go in diet mode, or we go into GLP-1 mode, right? But here, here’s the irony of this. They’re in front of you because their diet didn’t work.

[00:27:26] They’re gaining the weight because the diet didn’t work. They’re gaining the weight because, well, GLP meds did what they were supposed to do. Lost the weight, regained the weight when you stop taking them. So walk them through the next step. So if they’re, if they’re a traditional intentional weight loss, so okay, now what’s the solution?

[00:27:46] Are you gonna go back on a diet? If so, which one? What are you gonna do? What is going to be different this time than the last number of time you’ve been on a diet? Why will this time solving the weight gain with another diet, why will it be different? And then play the scenario with them full out so they can see that going back to the solution that caused them to lose weight, gain weight is just going to repeat itself again, and same thing with GLP-1, right?

[00:28:22] We… It’s interesting with GLP-1 because when I interviewed Regan Chaston in the Beyond GLP series, what she was telling me is that the longer study that are… I think the longest one was five years she was quoting, is that even though people were on the GLP for five years, they still regained the weight towards the end of the fourth and fifth year.

[00:28:48] Even though they were at the same dose the whole time, like the body is so efficient that it override the medicine. So Okay, so you’re gonna go back on GLP now. What’s gonna be different this ti- what, why did you stop the first time? And why is this reason why you stop will not be there in the future?

[00:29:12] Because if you go back on it, you have to stay on it for the rest of your life. Is that possible for you? Why, why did you drop off? Was it side effect? Was it money? Why is it gonna be different this time? Play out the worst-case scenario, very, uh, organized way so they can see that their solution doesn’t work, and then you can introduce, “Okay, so if you’re not gonna go back on the diet, if you’re not gonna go back on GLP-1, now what?

[00:29:45] What are you gonna do?” And this is the piece of coaching, right? What I like to call consent. “Okay, so if you’re not gonna do this, do you want us to explore another way?” But you need to get their consent to bring them into this other solution of body acceptance and body image, and that’s the… It’s… That logic or that approach to coaching comes from self-determination theory, right?

[00:30:14] Where you onboard a consensual agreement to go into there instead of being told what to do. So bring in their consent, and then explore another solution for them. Redefine body acceptance, body image work. Talk about health-promoting habits, and have them make a decision on how they wanna move forward to solve the problem of weight gain.

[00:30:40] Now, as I’m saying this, some of you are like, “Well, we’re not gonna help them lose weight.” Exactly. But when I say solving the problem of weight gain, just observe your home brain, right? Your home brain is like, “Well, but solving the problem of weight gain must mean losing weight.” Totally normal for you to think that, my dear coach, my dear professional.

[00:31:03] But from my perspective, solving the problem of weight gain doesn’t mean losing weight. It means body image work, body acceptance work, belief changes, like all the stuff that I do. So I can solve the problem of weight gain for people without getting them to lose weight, non-diet approach, right? Coaching. So that would be my approach with people.

[00:31:27] I’ll make one last caveat before I end this podcast, which is this one I’m talking about this very casually, right? You probably notice I’m very regulated, very, like, level set in this, and it’s… I wanna recognize again my privilege. I had to work through this myself. Like, my first three to four years of my 40s, call it from 40 to 43, was me making peace with my body, me making peace with never losing weight again, like the whole body acceptance.

[00:32:06] I had to do the work. So for me, I understand the journey, and I see the possibility because I’ve done it for myself. And I wanna invite you to kinda check in on yourself. Have you done this work for yourself? Because what I find when I work with professional in my mentorship program, the reason why they struggle is because they still have that fear hidden secret within them.

[00:32:37] They haven’t moved themself through the fear of weight gain. They haven’t accepted their body. There’s still a level of control, a level of anxiety, or they are in a thin body that they’ve never had to lose weight on. So they… It’s not because the fear is still there. The other category is, like, they’ve never gained weight in their whole life.

[00:33:04] So if the thin privilege is there or if you haven’t finalized doing the work for yourself and you haven’t moved yourself through this, I invite you to do this work. Because I predict, this is Stephanie’s prediction, we’re gonna have a body image crisis 2027 forward of all those people who have done another form of intentional weight loss with GLP-1, who for whatever reason cannot stay on it, will regain the weight, and they will be knocking at our door.

[00:33:44] So having the skill set to coach weight gain is gonna be the future of our industry. That’s my prediction, and, maybe I need to put Stephanie, re-listen to podcast 485 in five years from now, and let’s see if I was true. That’s my prediction, but I think the skill of coaching weight gain, coaching body image is the future of our industry Come and join us inside.

[00:34:12] If you’re listening to this in August 2026, come and join us inside of the Thursday session training series in August, because that’s what we’re talking about. That’s what I’m teaching. That’s what I’m talking about. We’re working through case study. I answer questions, so come and work with me there and consider perhaps the non-diet coaching certification which will start in September, the week of September 14, 2026.

[00:34:41] That’s when classes start for the next six months. It was a pleasure being with you. Hopefully, this will serve you and serve the people you’re working with, and I’ll see you on the next podcast episode.

[00:34:58] wanna coach behaviors, not bodies. Learn the mindset tool and the method that create real changes.

[00:35:05] Join the wait list for the next cohort of the non diet coaching certification at stephaniedodier.com/waitlist. That’s where the real training begins, and I’ll see you on the other side, my sisters.