I keep hearing a version of the same story from coaches this year. A client who has poured the same nightly glass of wine for a decade mentions, almost in passing, that she does not want it anymore. She started a GLP-1 medication for diabetes or weight management, and something nobody asked her to change, changed anyway.
Nobody prescribed that. It was not what the medication was for. But if you coach long enough, you will hear a version of this story too, and it is worth understanding what is actually happening before a client brings it to you.
GLP-1 is a hormone your own gut releases after you eat. It has a short life in the body, a matter of minutes, and it does several things at once: it prompts the pancreas to release insulin when blood glucose is elevated, it suppresses glucagon, and it slows the rate at which the stomach empties. Taken together, that is a system for keeping blood sugar stable after a meal.
The drugs are engineered versions of that hormone, built to survive far longer than the natural one. They were developed for type 2 diabetes, and they work.
The appetite effects emerged from that work rather than the other way around. Slower gastric emptying means food sits longer and a person feels full sooner. That produced weight loss, weight loss produced separate indications, and by the time these medications reached the cultural conversation, all of it had compressed into a single sentence about eating less.
So it should not be surprising that something else got missed.
Coaches started hearing something they had not expected. Clients on GLP-1 medications began mentioning, almost in passing, that they had stopped drinking. Or that they had lost interest in online shopping. Or that a thought they could not stop having had gotten quieter.
Nobody prescribed that either.
“I’m diabetic and overweight, so my doctor prescribed a GLP-1 for me. Yes, I lost weight. Yes, my A1C became more stable. And then I noticed that my desire for my nightly glass of wine disappeared. I’ve never been able to go to a party or dinner without having a few cocktails. Now, I am 8 weeks sober.”
— Coach360 reader, a 60-year-old woman on a GLP-1 medication for six months, who asked to remain anonymous
What the Drug Is Actually Doing Up There
GLP-1 receptor agonists work partly on receptors in the brain, and some of those receptors are located in regions involved in reward processing rather than digestion. The mechanism that reduces interest in a second helping appears to be operating on a broader system that governs wanting in general.
That is the part researchers have been chasing. If a medication turns down the volume on craving, the question becomes: craving for what, exactly?
The research on this is genuinely early and genuinely interesting, which is an uncomfortable combination because it invites overstatement. There is a growing body of work looking at reduced alcohol consumption in people taking these medications, some observational data on nicotine, and scattered reports involving compulsive behaviors. Trials are underway, and findings so far are suggestive rather than settled. Much of what has circulated publicly is drawn from patient reports and retrospective data rather than controlled studies.
Not All of These Claims Are Equal
The popular conversation treats every reported effect as equally supported. It is not close.
Alcohol has the strongest evidence, and phase 3 trials are currently underway. Nicotine, opioids, and stimulants are earlier in investigation, though the data looks promising.
Gambling and compulsive shopping are anecdote only. There have been no clinical trials, observational studies, or registry analyses, and no trial for GLP-1 and gambling disorder is currently registered. The reports are consistent and biologically plausible, but they are not evidence.
None of these uses are approved. Everything beyond diabetes and weight management is off-label, and the distance between a promising trial and an approved treatment is considerable.
The Mood Question, and What Changed in January
Beginning in 2023, reports of suicidal ideation among patients taking these medications prompted regulatory review. Those reports were taken seriously and investigated at scale.
In a Drug Safety Communication issued January 13, 2026, the FDA reported that its evaluation did not demonstrate increased risk of suicidal behavior or ideation, or of anxiety, depression, irritability, or psychosis. The FDA requested removal of the suicidal behavior warning from semaglutide, tirzepatide, and liraglutide labeling.
That is a more thorough investigation than most safety questions receive, and the result is reassuring. Residual uncertainty remains for psychiatrically vulnerable patients, particularly those co-prescribed antidepressants or benzodiazepines, and the FDA continues to advise ongoing patient discussion and mental health referral.
Which brings it to your gym floor. If a client on a GLP-1 says something that concerns you about their mood, the response is not to research it, and it is certainly not to reassure them based on a headline. Express concern directly and encourage them to talk to their prescribing physician.
What This Looks Like in Your Gym
If a medication is turning down the reward system, that system is not only involved in drinking and eating. It is involved in wanting things generally, including the things you are asking a client to want.
A client whose craving architecture has changed may find that a personal record does not land the way it used to. The rush after a hard session may be duller. The competitive pull that used to get them into the building on a bad day may have loosened its grip. Some describe a flatness, a sense that things they used to chase have gone quiet.
That is not a failure of motivation. It is worth recognizing, because the standard response to a client who seems less driven is to push harder or reach for a bigger goal, and both assume a reward system responding normally.
The tradeoff worth naming plainly: a client’s training can be working exactly as programmed while the emotional payoff that used to come with it has genuinely thinned out. Those are two different problems, and only one of them is yours to fix.
What tends to work better is shifting what the session is anchored to. Consistency and identity carry a client further than intensity when the dopamine payoff has thinned out. Showing up because this is who I am now holds up better than showing up because I want the feeling afterward, particularly when the feeling afterward has changed.
The other thing worth knowing is that muscle preservation matters enormously here, and that is squarely your work. A client losing weight rapidly is losing lean mass alongside fat unless resistance training and adequate protein are protecting it. That is programming, and it is the single most valuable thing you can do for a client on one of these medications.
Where Your Job Ends
You do not advise on medication, comment on dosing or side effects, or speculate about whether a client’s drinking changed because of the drug. You do not tell a client a medication might help their anxiety or their compulsive behavior, because that is a clinical claim about an unapproved use.
The new trial data makes this more important rather than less. A coach who reads about a Lancet result and mentions to a struggling client that there is a drug that might help their drinking has just practiced medicine badly.
What you do is notice, coordinate, and refer. Notice that a client’s drive has changed and adjust how you coach around it. Coordinate training with whatever guidance their physician has provided. Refer anything clinical, including mood changes, to the person who prescribed the medication.
Coaches sometimes hear that boundary as a limitation. It is closer to the opposite. A coach who stays clearly in scope is the coach a physician is willing to work with, and the coach a client trusts enough to tell the truth to.
Why It Is Worth Understanding
Some meaningful portion of your client base is either on one of these medications or considering it, and many are not telling you. They will notice which coaches understand what is happening to them and which ones are still treating it as a shortcut or a willpower question. Being someone a client can mention it to, without bracing for judgment, is worth more than any protocol you could offer.
Reward, motivation, and behavior change sit at the center of what coaching does. Coaches have been working with them, mostly by intuition and a stopwatch, for decades. The clinical challenge ahead is translating a mechanistic insight without turning every difficult habit into a drug target.
Something is happening in this research that touches the center of what coaches do. Most of it is still unproven. One piece of it just got considerably more real.
Related: Wearable Data in Coaching: Metrics and Referrals
FOR COACHES WORKING WITH CLIENTS ON GLP-1 MEDICATIONS
The coaches who understand where their expertise ends and a clinician’s begins are the ones facilities trust most. FitHire by Coach360 connects professionals with organizations that take scope, safety, and client care seriously.
Frequently Asked Questions
Do GLP-1 medications affect more than appetite?
GLP-1 acts as a neurotransmitter in brain regions governing reward, including the mesolimbic dopamine pathways, not only in the digestive system. In May 2026, The Lancet published the first randomized controlled trial evidence that semaglutide significantly reduced heavy drinking days in patients with alcohol use disorder and obesity compared with placebo over 26 weeks. Reports also exist regarding nicotine, gambling, and compulsive shopping, though the evidence quality varies enormously. None of these applications are approved uses, and any prescribing for them is off-label.
Can GLP-1 medications treat addiction or compulsive behavior?
Not as an approved treatment, though the alcohol evidence is now meaningfully stronger. The May 2026 Lancet trial found a number needed to treat of 4.3 for semaglutide, compared with 7 or higher for medications already approved for alcohol use disorder, and phase 3 trials are underway. Nicotine data show real signal, while opioid and stimulant research is earlier. Gambling and compulsive shopping remain anecdotal, with no clinical trials or registered studies. Fitness professionals should never present any of these possibilities to clients as established.
Is there a link between GLP-1 medications and depression or suicidal ideation?
The FDA investigated and did not substantiate it. In a Drug Safety Communication issued January 13, 2026, the agency reported no increased risk of suicidal behavior or ideation, or of anxiety, depression, irritability, or psychosis, based on a meta-analysis of 91 placebo-controlled trials covering 107,910 patients and a retrospective cohort of more than 2.2 million patients. The FDA requested removal of the warning from semaglutide, tirzepatide, and liraglutide labeling. Residual uncertainty remains for psychiatrically vulnerable patients, and the FDA continues to advise patient discussion and mental health referral.
How might a GLP-1 affect a client’s motivation to train?
If these medications influence reward pathways broadly rather than appetite alone, some clients may find achievements and hard sessions no longer produce the same emotional payoff. Coaches may observe this as reduced drive or general flatness rather than an adherence problem. The productive response is to anchor training in consistency and identity rather than the feeling that follows a session, and to avoid the reflex of pushing harder, which assumes a reward system responding typically. Muscle preservation through resistance training and adequate protein remains the highest-value coaching contribution.
What should a coach do if a client on a GLP-1 mentions mood changes?
Refer, directly and promptly. Even with a reassuring regulatory finding, monitoring remains advised, and evaluating a client’s mood is not within a coach’s scope regardless of what the research says. Express concern and encourage them to speak with their prescribing physician. Coaches should not research the question on a client’s behalf or offer reassurance based on headlines.
Jessica H. Maurer covers health and longevity for Coach360News.
About Jessica H. Maurer
Jessica is a recognized fitness business consultant and strategist focusing on transforming businesses from overwhelmed to organized. Her international presentations, workshops, certifications, and consultations underscore her commitment to helping fitness professionals and businesses realize their full potential. When Jessica takes the stage, she’s sharing fresh ideas and inspiration that spark positive change. Jessica’s international presentations and consultations are about growth, career transformation, overall wellness, and making fitness a joyful journey. Her expertise spans education, program and instructor development, and brand evolution, making her a key player in elevating the industry. Jessica also played a pivotal role in developing the Mental Well-being Association’s certification for Fitness Professionals., always striving to bring a holistic approach to wellness that’s as uplifting as it is effective.
Jessica has presented at prestigious events like IDEA World, Fitnessfest ACSM Health & Fitness Summit, SCW Mania, AsiaFit, and more. She has worked with brands such as FIT4MOM, SFR, BOSU, Lebert Fitness, Savvier Fitness, SCW Fitness, FitSteps, canfitpro, IDEA, and VIBES music. She also has written content for the IDEA Fitness Journal, canfitpro Magazine, Mental Well-being Association, FIT4MOM, Motherly, and more.
