Objectives: Current clinical obesity management is insufficient in helping patients initiate and sustain weight loss, requiring innovative and efficacious interventions. We investigated health and wellness coaching in clinical care to motivate patients to adopt healthier lifestyles towards weight management, and proposed an efficacious approach to integrating coaching into clinical care for weight management. Methods: We conducted a systematic review of literature for the past 10 years concerning health and wellness coaching for weight loss in a primary care setting. Relevant articles were organized by the approach that coaching was applied towards weight management. Studies were considered efficacious if the coaching intervention resulted in clinically meaningful weight loss (> 5% initial body weight in six months) or was statistically significant compared to control/standard care. Results: Health and wellness coaching in a variety of clinical settings at moderate-to-high frequency dosages was most efficacious in helping patients achieve and sustain clinically meaningful weight loss, as seen in nine of the thirteen studies examined. Other results of coaching included improved diabetes and cardiovascular risk factors, healthy lifestyle behaviors, and self-sufficiency for maintaining these changes. Conclusions: Health and wellness coaching incorporated into clinical care results in positive health outcomes. It is recommended for clinicians to integrate coaching into the clinical care of obese and overweight patients. We propose coaching for weight management should be delivered at least a moderate frequency (>1/month) by a trained health and wellness coach. Further, coaching can be personalized to SUIT patient needs and optimize care.