Anyone pursuing weight loss has probably heard the mantra, “eat less, exercise more.” While there’s some truth to the principle, for most people it’s not that simple. For individuals using GLP-1 medications as a tool to help them manage weight, things get even more complex.
“Treating the disease of obesity requires an individualized approach,” says Dr. Benjamin Duffy, an Obesity Medicine Specialist who leads the ThedaCare Weight Wellness Solutions program. “If you choose to use these powerful medications in your treatment plan, it’s best to select a program that includes the oversight of an obesity medicine specialist in order to minimize side effects and maximize your results.”
GLP-1s, Explained
GLP-1 medications include drugs like Ozempic, Wegovy (semaglutide) and Mounjaro (tirzepatide). They were designed to help manage blood sugar and glucose levels in people with type 2 diabetes. Later, they were also discovered to slow digestion and suppress appetite. This can help people eat less, and therefore help treat obesity.
Eating less creates the “caloric deficit” necessary to lose weight. With these medications, this means you eat fewer calories than your body can use in a day. At the same time, shedding pounds in this way can lead to loss of muscle mass, Dr. Duffy says.
“The body doesn’t target fat loss and preserve your muscle,” he continues. “It simply responds by losing weight.”
Importance of Strength Training
“Taking a GLP-1 can lead to a loss of muscle mass over time,” says Amanda Atkinson, an Exercise Physiologist with ThedaCare Bariatrics. “To combat that, we recommend strength training, along with eating a high-protein diet. Together, these strategies can help people maintain their muscle mass.”
Strength and resistance workouts build and maintain muscle mass through exercise that works against a force or weight. Strength training includes activities like weightlifting, squats, lunges, bench presses and rowing. Resistance training can include exercises such as yoga or Pilates, which use your body weight as the force.
“Strength training is vital for anyone who is working to lose weight, and it’s particularly important for those who are on GLP-1 medications,” Atkinson says. “Building muscle mass can help you lose more weight, even though you’re not burning as many calories during the workout.”
How Muscle Helps
“When most people think of muscle, they picture big biceps or chiseled abs,” Dr. Duffy says. “But muscle is not just about appearance. It’s one of the most important organs in your body. In fact, when it comes to your health, muscle acts as your body’s metabolic engine.”
Just like a car engine burns fuel to create movement, your muscle burns calories to keep you functioning and thriving, Dr. Duffy says. It uses energy not only during exercise, but even while you are resting. The more muscle you have, the more efficiently your body manages blood sugar, insulin and inflammation.
Muscle also helps you:
- Burn more calories, even at rest
- Manage blood sugar and reduce your risk of diabetes
- Stay strong, mobile and independent as you age
- Protect against weight regain after fat loss
- Recover more quickly from illness or injury
“I often refer to muscle as metabolic armor,” Dr. Duffy says. “It’s doesn’t only make you stronger — it helps protect your long-term health.”
Stronger, Longer
People often experience metabolism slowdown after weight loss because they’ve lost muscle, so their body needs fewer calories for energy.
“When you keep or build your muscle, it’s easier for your body to lose fat,” Atkinson says.
Cardio is still important for overall health, including reducing the risk of heart disease and managing stress. However, Dr. Duffy says he always encourages people on GLP-1s to prioritize strength training.
“Building and maintaining strength is key because it can help prevent the loss of muscle mass that can come with the rapid weight loss associated with taking a GLP-1,” he says. “For that reason, I often tell my patients that when it comes to working out, err on the side of choosing strength workouts.”
Strength Training Fundamentals
Always talk to your health care provider before adding an exercise routine to your wellness plan.
“If you’re a beginner and aren’t sure what activity would be best for you, our team can offer recommendations,” Atkinson says.
Start slowly. Warm your body up with a few minutes of dynamic stretching before starting your strength training workout. To help prevent injury, begin with lighter weights and increase weight and intensity gradually. Vary your routine to keep all your muscle groups working. For example, focus on upper body one day and lower body the next.
Modify as needed. Pay attention to your body, especially when you’re first adding new exercise. Proper form is crucial to avoiding injury. Seek medical advice if you experience any unusual discomfort, fatigue or dizziness. If your GLP-1 medication causes side effects like gastrointestinal problems, keeping your workout intensity low may help you still complete it while minimizing discomfort.
Pick activities you like. “It’s easy to get overwhelmed with a new exercise routine, and that can kill your motivation,” Atkinson says. “Try new activities, and find ones you enjoy and look forward to. The longer you stick with it, the likelier you are to build a lasting routine.”
Get some help. Most fitness centers have appointments available with a trainer. They can develop a workout that considers your fitness level and health conditions. It’s a good way to learn the equipment and understand how each piece will target certain muscle groups. Many offer yoga, Pilates and other classes as well.
Fuel properly. Drink enough water, and ensure you’re focusing on good nutrition. When it comes to diet, make sure to take in plenty of protein. The ThedaCare Weight Wellness Solutions team can help you determine your protein goals.
Make time for rest. Once you start an exercise routine, you may find it’s hard to give yourself a break. Rest days — and adequate sleep — are crucial to giving your muscles the time they need to recover between workouts.
Focus on the Long Term
“In a world that often focuses on losing weight, I believe it’s just as important to focus on what you are building,” Dr. Duffy says. “Muscle is not something you simply tone. It’s something you train, nourish and preserve — because your health depends on it.”
