BACKGROUND: Health coaching promotes healthy lifestyles and may be particularly helpful for employees with chronic disease. OBJECTIVE: Evaluate the effects of a health coaching program that targeted health-system employees with at least one cardiovascular disease (CVD) risk factor. METHODS: Fifty-four employees volunteered for a health coaching program (6-session, 12-week program, at least one cycle). 40 (74%) completed (mean age [SD] = 53.3 [10.3] years, Female = 95%, Caucasian = 83%). A certified and integrative health coach/nutritionist provided coaching. Self-reported outcomes were collected using a pre-post design. RESULTS: Participants reported high rates of obesity (75%), hypertension (52.5%), diabetes/prediabetes (47.5%), and hyperlipidemia (40%). In addition, 20% reported chronic pain/rehabilitation needs, 17.5% seasonal depression, and 30% other significant co-morbidities. Following coaching, participants reported significant weight loss (mean [SD] 7.2 [6.6] pounds, p < 0.0001, d = 1.11), increased exercise (from 0.8 to 2.3 sessions/week, p < 0.001, d = .89), reduced perceived stress (p < 0.04, d = .42), and a trend for improved sleep (p = 0.06, d = .38). Reduced stress correlated with both increased exercise (r =-.39, p < 0.05) and decreased fatigue (r = .36, p = 0.07). CONCLUSION: Health coaching for healthcare employees with obesity and other CVD risk factors is a promising approach to losing weight, reducing stress, making healthy lifestyle changes, and improving health and well-being.