By Shruti Javali, MD
There’s no denying it—weight loss medications have changed the rhythm of our exam rooms. These days, I can’t go a week without someone asking about “that shot.” For some of my patients, these medications have been life-changing. For others, they’ve brought side effects, confusion, or disappointment when access or insurance coverage suddenly changes.
As family physicians, we’ve found ourselves right in the middle of this new landscape—prescribing for some, troubleshooting for others, and trying to keep up with the science as it evolves. But as the system around us continues to shift, this moment has reminded me to double down on what we do best: meeting patients where they are, and helping them make meaningful, sustainable changes regardless of what’s happening with their prescriptions.
Our patients deserve more than “eat less, move more.” They deserve specific, actionable guidance that fits their lives and builds confidence over time. That’s why in my clinic, I’ve gone back to something simple but surprisingly effective: SMART goals. Whether or not a patient is on a GLP-1 medication, every conversation about weight management ends with one or two Specific, Measurable, Achievable, Relevant, and Time-bound goals we set together and revisit at each visit.
Sometimes it’s as basic as cutting down soda from daily to three times a week. Other times, it’s as detailed as tracking macronutrients to increase protein intake. Exercise goals follow the same logic—starting with a 20-minute walk three times a week for a sedentary patient, or building toward weight training for someone ready to take the next step.
We document these goals just like any other part of the care plan. Reviewing them together helps patients see progress, even when the scale doesn’t move, and turns each visit into a small accountability checkpoint. It also reminds both of us that consistent, realistic change is the cornerstone of long-term success—medication or not.
What I’ve learned is that this approach helps patients focus less on the prescription and more on the process. Those small, specific wins add up over time—and often, they’re what turn “I tried” into “I did.”
Learn More:
Wren GM, Koutoukidis DA, Scragg J, Whitman M, Jebb S. The Association Between Goal Setting and Weight Loss: Prospective Analysis of a Community Weight Loss Program. J Med Internet Res. 2023 Jul 5;25:e43869. doi: 10.2196/43869.
Bailey RR. Goal Setting and Action Planning for Health Behavior Change. Am J Lifestyle Med. 2017 Sep 13;13(6):615-618. doi: 10.1177/1559827617729634.
