Incretin therapies, GLP-1 and dual GLP-1/GIP receptor agonists, have moved from specialist endocrinology clinics into everyday practice conversations. Clients are arriving to appointments having already researched these medications (sometimes already having them prescribed) and increasingly asking practitioners across nutrition, psychology, and allied health to help them make sense of what they’re taking or considering.
It’s tempting to meet this moment with a stance, either steering clients firmly toward these medications as a metabolic health tool or cautioning them away on weight-inclusive grounds.
Eat Love Live Education built the DECISION framework to ensure the client remains at the centre of our conversations.
The framework is neutral by design: not weight-centric, not weight-inclusive, but client-centred. The practitioner’s job in this conversation isn’t to decide for the client, and it isn’t to talk them out of or into a decision they’ve already started forming. It’s to make sure that whatever they decide, they’re deciding with full information, in a supported way, with appropriate safeguards in place.
That’s what informed consent actually requires. Not just a rundown of side effects, but a genuine two-way conversation about goals, research, risk, and readiness; one that leaves space for ambivalence, curiosity, and clients changing their minds partway through.
What the framework covers:
DECISION is structured as eight checkpoints a practitioner can move through with a client, in order or as the conversation naturally unfolds. It opens with discussing the client’s actual request and the goals or clinical indications sitting behind it. Because, “I want to try a GLP-1”,can mean very different things for each individual, who will each have their own motivators; its subjective.From there, practitioners explore the current research together with the client, rather than delivering it as a verdict, and address concerns around side effects and nutritional risk in real detail rather than in passing.
A central checkpoint asks practitioners to consider interaction with a current, past, or emerging eating disorder; screening where indicated and referring on if needed. This isn’t a formality; incretin therapies alter appetite and eating behaviour directly, and that intersects with disordered eating risk in ways that deserve direct, unhurried attention rather than assumption in either direction.
The remaining checkpoints keep the relationship going after a decision is made: giving clients room to sit with information before committing, initiating health-centred (not just weight-centred) goals if they proceed, staying engaged through ongoing discussions and risk monitoring, and notifying the broader care team so the decision and any risk management plan doesn’t live with one practitioner alone.
Why the framing matters
A weight-centric approach risks treating incretin therapies as a default good, sidelining legitimate concerns about side effects, sustainability, or a client’s relationship with their body. A weight-inclusive approach risks the opposite; projecting caution or disapproval onto a client who has made a considered, informed choice for reasons that are theirs to weigh. Both stances substitute the practitioner’s judgement for the client’s own.
DECISION is an attempt to hold the line in between: practitioners bring expertise, current research, and clinical safety screening to the table, but the client’s autonomy and their own reasoning stay at the centre of the decision. That’s a harder conversation to have than a scripted for-or-against, it takes more time, more listening, and more willingness to sit with a client’s ambivalence. We think it’s worth it.
We’re Jo and Christie—Accredited Practising Dietitians and Credentialed Eating Disorder Clinicians with a shared passion for disordered eating, eating disorders and body image work.
Our resources are developed alongside people with lived experience and designed for health professionals who want to deliver high-quality, client-centred care.