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Fitness · By Dave Vaughan

Why strength training matters when you're losing weight on Ozempic or another GLP-1

Summary: GLP-1 medications help many people lose weight fast, but part of what's lost can be muscle. Lifting two to three times a week and eating enough protein are the practical ways to keep strength while the scale drops. This is fitness guidance — your prescriber manages the medication.

Does weight loss on a GLP-1 include muscle?

Usually some, yes. Any significant weight loss includes some lean tissue, not just fat. In the large STEP 1 semaglutide trial, a body-composition subgroup lost lean mass along with fat mass.1 Weight comes off quickly on these medications, and appetite is often low, so it's easy to under-eat protein and skip training — two habits that make muscle loss worse.

Why does keeping muscle matter?

Muscle is what lets you climb stairs, carry groceries, get off the floor and stay steady on your feet. Keeping it also makes the weight you lose more likely to be fat, and it helps you feel strong rather than just smaller. In dieting older adults, programs that included resistance training preserved more lean mass and physical function than diet plus cardio alone.2

What should workouts look like on Ozempic or a GLP-1?

  • Strength first, 2–3 days a week. Squats or sit-to-stands, pushes, rows, hinges and carries. Federal guidelines recommend muscle-strengthening work on at least two days a week.4
  • Moderate effort. Finish each set with a couple of reps left. You're protecting muscle, not chasing exhaustion.
  • Shorter sessions, longer rest. 20–30 minutes with full rests beats a punishing hour you can't repeat.
  • An easy option for rough days. On low-energy or nauseous days, a walk and some mobility still counts.
  • Stop if something's off. Dizziness, lightheadedness or feeling unwell means stop, sit, hydrate, and check with your prescriber if it continues.

How much protein do you need?

Protein matters more when you're eating less. Research on preserving muscle during weight loss points to higher protein intake combined with resistance exercise as the most supported approach.3 When appetite is low, think smaller, protein-dense options: Greek yogurt, eggs, cottage cheese, a protein shake, lean meat or fish. Eat the protein first. Your prescriber or a registered dietitian can set targets for your situation.

Fitness guidance vs. medical advice

Nothing here changes how you take your medication. Dose, side effects, and whether exercise is safe for you are questions for your prescriber. What a coach can do is help you train consistently and sensibly while that happens.

Want this planned for you?

Play By Dave has a dedicated track for people losing weight on a GLP-1: short strength sessions, protein-first targets, and daily adjustments for low-energy days. See workouts for people on Ozempic.

About the author: Dave Vaughan is a personal trainer with a B.S. in Exercise Science, the NSCA CSCS certification, and 25+ years coaching. He is not a medical provider.

References

  1. Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med. 2021.
  2. Villareal DT et al. Aerobic or resistance exercise, or both, in dieting obese older adults. N Engl J Med. 2017.
  3. Cava E, Yeat NC, Mittendorfer B. Preserving healthy muscle during weight loss. Adv Nutr. 2017.
  4. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition.