Medication alone vs coaching: Which GLP-1 approach works?

GLP-1 medications like Wegovy, Zepbound, and Ozempic have fundamentally changed the weight loss conversation. They’re highly effective, fast-acting, and wildly popular — with prescription volumes growing over 300% since 2020.

But there’s a catch many employers are now confronting:

Medication alone rarely delivers lasting results — and it comes with escalating costs, dropout risk, and little accountability.

In most GLP-1 programs, employees get access to a prescription… and that’s where the support ends. No structured follow-up. No lifestyle change. No off-ramp plan.

That model leads to rising pharmacy spend, poor long-term outcomes, and an employee population dependent on a drug they can’t afford to stop.

Let’s break down why that approach doesn’t work — and what does.

GLP-1s work — but behavior still drives outcomes

There’s no doubt GLP-1s are powerful. They suppress appetite, regulate blood sugar, and can lead to 15–20% weight loss in some patients. But they don’t do it alone — and they don’t change behavior.

In a typical “medication-only” model:

Patients may see rapid initial weight loss
But 50–70% stop taking the drug within a year (AJMC Study)
And those who stop regain much of the lost weight within months (JAMA)

Why? Because the root causes — emotional eating, stress, sleep issues, movement patterns — were never addressed.

As soon as the medication stops, old behaviors return.

That’s what makes medication-only models so risky for self-funded employers:

You’re paying for results that often disappear the moment the prescription ends.

The evidence: Coaching changes everything

Behavior change isn’t optional — it’s essential.

When GLP-1s are combined with structured, psychological coaching, everything improves:

Weight loss is more gradual and sustainable
Side effects are easier to manage
Members build habits that stick after medication ends
Employers see better ROI through long-term cost control

At Embla, we’ve seen it firsthand.

Our coaching model is built around Acceptance & Commitment Therapy (ACT) — a clinically backed framework used to improve behavior, motivation, and mental flexibility.

Each member works 1:1 with a trained coach who helps them:

Identify personal drivers of eating behavior
Create habits around movement, sleep, and stress
Set goals and maintain accountability
Prepare for life after GLP-1s

And our clinical team ensures medication is used strategically — starting at the lowest effective dose and only increasing when truly necessary.

The results: Coaching drives more results with less medication

Across thousands of Embla members, we’ve found that this combined approach leads to:

16.7% average weight loss in 12 months
Achieved using 66% less GLP-1 medication
With 8 in 10 members successfully tapering off without weight regain

This is the key insight for employers:

It’s not just about the drug. It’s about the support system that surrounds it.

With the right behavioral framework, members achieve better outcomes and need less medication to get there — reducing both short- and long-term spend.

A closer look: What coaching actually includes

Here’s what “coaching” looks like inside a true clinical-grade weight loss program like Embla:

Component	Medication-only program	Embla coaching-based program
Initial support	Prescription issued	Clinical intake + goal-setting
Ongoing touchpoints	None or app-only	Weekly 1:1 video sessions
Behavior change methods	None	ACT-based behavior change tools
Side effect management	Left to member	Proactive coaching + clinician guidance
Medication strategy	High dose by default	Lowest effective dose with structured taper
Post-medication support	None	Full off-ramp plan and long-term check-ins
Outcome tracking	Not available	Transparent employer-facing reporting

For employers, coaching = ROI

GLP-1s alone are expensive. But GLP-1s without lasting change are even more costly.

A program that includes expert coaching helps employers:

Avoid over-reliance on high-dose medication
Support safe, successful tapering
Reduce pharmacy costs by 2x–3x
Improve engagement and adherence
Reduce obesity-related claims (diabetes, MSK, hypertension)

For every dollar spent on coaching, employers save multiples in future claim prevention and reduced drug dependency.

In other words:

Coaching isn’t a “nice to have.” It’s the lever that makes GLP-1 coverage sustainable.

Coaching isn’t optional — it’s the missing piece

If you’re offering a GLP-1 weight loss benefit without structured support, you're taking on long-term cost without long-term value.

Medication gets people started. Coaching helps them finish.

Want to see how Embla delivers better outcomes using 66% less medication? We combine psychology-based coaching, clinical GLP-1 management, and fully digital care — built for self-funded employers. Reach out to learn more.