Make it a Habit: GLP-1s and fitness: Why muscle matters

Ozempic, Wegovy and Mounjaro. You’ve probably heard of these medications, whether you have read about them in the media or your doctor has prescribed one for you. They belong to a class of drugs called GLP-1s. Originally designed to treat Type 2 diabetes, the ability of these drugs to suppress appetite and promote weight loss has fueled their surge in popularity.

If you are taking one of these medications or considering it, lifestyle change is key to maximizing their benefits. Of the many lifestyle changes you could make, put fitness at the top of your list. And when it comes to fitness, make strength training, another way of saying weightlifting, your priority.

Why muscle mass matters

GLP-1s help the pancreas release insulin, lowering blood sugar levels. They also slow digestion and signal fullness to your brain. Together, those effects can lead to significant weight loss. You eat less, and it is calorie reduction that promotes weight loss.

Early research suggested that overall weight loss when taking a GLP-1 also produced major muscle loss. A 2022 New England Journal of Medicine study found the effect was not as significant as first believed. Fat-to-lean muscle mass loss ratios for adults taking GLP-1s were similar to those seen with conventional diet or surgical interventions.

Still, weight loss of any kind always involves some reduction in muscle mass. Muscle mass extends your health span by supporting metabolic health, physical strength, endurance, mobility and balance. Sarcopenia, or the loss of muscle mass that comes with age, is a leading cause of frailty among older adults. Strength training is one of the easiest and most accessible ways to preserve muscle mass. It also outperforms walking or other forms of cardio exercise as a tool to change body composition and preserve muscle mass.

Building a smarter routine

If you are taking – or considering – a GLP-1, here are six ways to protect your muscle mass and make your fitness program sustainable.

Start with your physician. Get personalized advice around exercise, especially if you have health conditions that impact your ability to exercise or if you are new to exercise.

Start slowly. Ease into fitness with walking, stretching and low-impact cardio. Then, build up to 2 to 3 days per week of strength training. Keep up with moderate cardio exercise in addition to strength training, not instead of it.

Mix it up. Augment strength training with flexibility or balance work for maximum benefit and to keep your workouts fresh and more enjoyable.

Stay hydrated and nourished. Proper fuel supports both exercise and recovery. A registered dietitian can help you to design a plan that meets your unique needs.

Listen to your body. Fatigue, dizziness or unusual pain when training are signs to adjust. Again, ask your physician for guidance.

Track it. Consider a body composition scan when you start GLP-1 treatment and repeat it at scheduled intervals throughout treatment. Scanning equipment is available through independent providers. Knowing your baseline and seeing change over time can encourage you to keep going. Track your workouts to confirm that you are meeting basic fitness requirements. Use this data to celebrate your accomplishments or to recalibrate your approach.

Overcoming Challenges

Common GLP-1 side effects can derail your best intentions. If you are feeling nauseous, shift your workout times or choose gentler activities.

Struggling with motivation to exercise? Add accountability. Making a commitment to a personal trainer or workout buddy makes it more likely that you will follow through.

Feeling discouraged? Lifestyle change or habit formation takes time. Tie how the strength training you do today will give you the improved health span you want in the future. And remember, fear and shame are not great motivators, especially in the longer term.

Too busy? Get creative. Three short strength training sessions can equal one longer session.

And don’t forget to celebrate. Small wins add up. Find a way to recognize what you have accomplished and the hard work it took to get you there. Then, keep going!

Lisa Keer Carusone, a Weston resident, is a national board-certified health and wellness coach and a certified executive coach. She coaches adults of all ages and life stages at Massachusetts General Hospital’s Center for Specialized Healthcare Services in Boston.