You may have heard of the various GLP-1s out there, Ozempic, Wegovy or Mounjaro are a few of the big ones. You may have seen the news or maybe even an ad touting their weight loss effects.
I want to state from the top, that this post will not be pro or anti these meds. If you have used them, if you are thinking about using them or if you are currently using them-you do you!
What I do want to talk about in this post is the fact that strength training is really necessary when using these types of medications. As a fitness coach I have worked with and work with folks who use and have used these medications as part of their health and wellness journey with their doctor. When in conversation with people, not everyone is as aware of actually how much strength training is necessary to help mitigate the muscles loss that will happen when using these medications.
But First the Research
Research shows (here, here and here) that the weight loss people experience is both fat loss and muscles loss. One of the most recent studies talked about how fat loss was ~7.9kg and muscle loss was ~6.4kg. The researchers thought that the fat loss was more substantial. They did also acknowledged that muscle mass loss is not negligible, but the preservation of a greater proportion of lean mass relative to fat is promising. Additional research has talked about the need for strength training (here and here) and to a lesser extent nutritional intervention for those taking these medications to help maintain lean muscle mass.
Additionally there are smarter people out there than me talking about the harm the weight loss industry can cause when these semaglutide or tirzepatide drugs (like the ones listed above) are in shortage and people are told to use options from Compounding Pharmacies. If you want to know more feel free to read this or listen to the Maintenance Phase episode.
Strength Training
So let’s talk about the need for strength training to help mitigate the loss of muscle. Whether you are going to strength train at a gym or in your home, with a trainer or without, it’s important to focus on multijoint movements (squats and deadlifts) and also progressively making them harder as the movements get easy. This means picking up heavier weights.
Multijoint Movements
These are movements like squats, deadlifts and lunges, elevated hip lifts, for your lower body. And for your upper body movements like push-ups, pull downs or pull-ups, rows and overhead presses. These are just a few exercises you can do for upper and lower body; there are plenty of more options.
For some really great ideas for what to do if you are not sure you can check out a previous article where we share a great outline or head over to our YouTube Playlists we have some exercises you can mix and match for a good full body workout.
Also, you don’t need to workout every day. You can get a lot of mileage with two really focused workouts in a week that incorporate many of the multijoint movements listed above or in the links above. Of course everyone is different and listening to your body is important to ensure you are making steady progress towards your goals, but also resting and not over doing it.
Progressive Overload
Progressive overload is: as the movements get easy with either body weight or the weights you’re using, you need to pick up heavier weights. Doing more and more reps, like 20 or 30 reps, of one exercise at body weight does’t really help get you stronger and it makes the workout really long. And let’s be honest, in this capitalistic society-who’s got time for that!
There is a nice general sweet spot of repetitions (reps), especially if you are just starting out and that is somewhere between 8-12 reps. There are more repetition and set (how many times you do the required reps) break downs out there and those can change as you workout more and your training age increases. But I don’t plan to go into those here.
Training age refers to how long someone has been consistently engaged in structured fitness training. It doesn’t correlate to your actual age.
To help counteract the muscle loss that will be part of the weight loss while using these meds, it is very important to check in with how you are feeling in your workouts. Most specifically you want to assess if at the end of the reps you did for your squat, for example, that you can do one or two more with good form, but that is it. If you can do 3, 4, 6, 10 more reps, the weight you were using, be it body weight or additional resistance, isn’t enough to help gain strength or even mitigate muscle loss.
So check in and pick up heavier things!
Nutrition
Another thing that can help mitigate muscle loss is eating enough lean protein sources throughout your day. Protein helps build muscle and you will probably have to eat a little more than you are used to.
We’re not into counting calories, but tracking may be useful at this time, so we prefer the hand method. What’s that you say? Using your hand to help know if you are getting a good portion of, in this case, protein. One portion of protein is the size and thickness of your palm.
Think one chicken breast, two eggs, or almost a cup of greek yogurt. Don’t get me wrong it’s a little hard to figure out what’s a palm size of some vegetarian and vegan options. It’s good to shoot for 1-2 palm sized portions of protein per meal. If you are a smaller person one to one and a half palms of protein per meal and if you are a bigger person you will want two palms. Depending on activity level you may even need more than two palms at each meal.
I know that might seem like a lot, but start by first figuring our what you are eating now and then slowly up it. Eating one egg at breakfast now, try adding another one or even a half (and save the other half for a different day). Or maybe now you put only a few chicken strips in a sandwich at lunch and you add one or two more strips to take in that extra protein. Start slow and slowly work up to a little more at each meal. Other food items might need to tweaked to be a bit less to accommodate the extra protein.
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Today I hope I was able to share the importance of strength training while taking any GLP-1 to help mitigate the muscle loss that will happen with these meds. Some of the folks I have worked with have shared that they could feel themselves not feeling as strong while taking these meds. We made adjustments to the resistance and talked about protein and rest and these things helped. But also, every day is a new day.
Whatever a person decides to do while consulting with their doctor (which I know can have issues in and of itself because of fat phobia in the medical field), I have seen that not everyone has been told that they will also be losing muscle too and the need for strength training to help alter how much that will be. So take this knowledge and use it. Or do what you want with it. You’re the boss of you.
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If you have any questions don’t hesitate to reach out. If you want to come in and chat about nutrition or fitnessing with us, book your fitness consult and let’s chat!