Sarah Lyall-Neal, PsyD
Psychologist
Cleveland Clinic Akron General
In recent years, GLP-1 RA medications have soared in popularity among individuals looking to reduce weight and improve their overall health. As with any lifestyle change, weight loss utilizing GLP-1 RA medications can have moments of triumph and moments of struggle. As psychologists, we can assist our clients on their health journeys by providing individualized behavioral and emotional support.
For best results, GLP-1 RA medications should be utilized in conjunction with healthy lifestyle changes. If individuals take these medications without making lifestyle changes, they may see weight loss due to reduced energy intake, but will not achieve optimal results in terms of body composition and overall improvement of health (Wadden et al., 2023). Further, lifestyle changes are necessary to reduce the expected weight regain associated with discontinuation of the medication (Ahmed, 2024).
From a behavioral standpoint, psychologists can serve a pivotal role in their clients care by utilizing therapeutic techniques such as motivational interviewing to aid clients in tapping into their intrinsic motivation for lasting change. Along with utilizing motivational interviewing, psychologists can aid patients in setting SMART goals to help individuals stay on track throughout their weight loss journey. Additionally, psychologists can aid patients in planning and completing logistical tasks such as meal planning and thinking about ways to incorporate fitness into their routine.
From an emotional standpoint, psychologists can aid clients taking GLP- 1 RA medications in several ways. Research has shown a bidirectional link between mental health disorders and overweight/obesity, meaning a person with an underlying mental health disorder is more likely to experience overweight/obesity and a person with overweight/obesity is more likely to experience mental health concerns (Steptoe & Frank, 2023). Psychologists can assess, diagnose, and provide care to aid the patient in coping with any underlying mental health concerns that could be a barrier for the individual to reach their health goals. Along these lines, psychologists are also uniquely suited to assess mood changes in their clients who have begun taking a GLP-1 RA medication. GLP-1 RA medications have been noted to affect brain regions involved in emotion regulation, with at least one case study indicating worsening depression symptoms after a patient took Ozempic (Manoharan & Madan, 2024).
Psychologists can also aid clients in coping with the emotional aspects of being on a weight loss journey. For example, for patients who have relied on food for coping, changing their relationship with food can be distressing. Psychologists can utilize therapeutic techniques such as Cognitive Behavioral Therapy (CBT), an evidenced based intervention, to assist patients in changing their mindset and developing coping strategies that are aligned their long-term goals.
The most important thing to keep in mind when working with patients who are on a weight loss journey is the fact that one size does not fit all when it comes to their needs. It is imperative that we, as psychologists, engage in active listening and provide each client with the personalized support they need. Beyond our work with individual clients, it is also our job as psychologists to work to end the stigma that is still in effect today toward people living in bigger bodies. Everyone deserves to take up space no matter their size.
References
Ahmed, I. A. (2024). A comprehensive review on weight gain following discontinuation of glucagon-like peptide-1 receptor agonists for obesity. Journal of Obesity, 2024, 8056440. https://doi.org/10.1155/2024/8056440
Manoharan, S. V. R. R., & Madan, R. (2024). GLP-1 agonists can affect mood: A case of worsened depression on Ozempic (Semaglutide). Innovations in Clinical Neuroscience, 21(4-6), 25–26.
Steptoe, A., & Frank, P. (2023). Obesity and psychological distress. Philosophical Transactions of the Royal Society B: Biological Sciences, 378(1888), 20220225. https://doi.org/10.1098/rstb.2022.0225
Wadden, T. A., Chao, A. M., Moore, M., Tronieri, J. S., Gilden, A., Amaro, A., Leonard, S., & Jakicic, J. M. (2023). The role of lifestyle modification with second-generation anti-obesity medications: Comparisons, questions, and clinical opportunities. Current Obesity Reports, 12(4), 453–473. https://doi.org/10.1007/s13679-023-00534-z