Staying Strong While Taking GLP-1 Medications: Your Exercise Guide
What You Need to Know About Exercise and Your GLP-1 Medication
If you're taking a GLP-1 medication like semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound), or liraglutide (Victoza, Saxenda), congratulations on taking an important step toward better health! These medications are powerful tools for weight loss and managing diabetes. However, to get the best results and stay healthy, exercise—especially strength training—is just as important as your medication.
Why Exercise Matters Even More on GLP-1 Medications
GLP-1 medications help you lose weight by reducing your appetite and helping you feel full longer. While this is great for weight loss, there's an important fact you should know: about 20-40% of the weight you lose may come from muscle, not just fat.[1]
Losing muscle can lead to:
- Feeling weaker and more tired
- Difficulty with daily activities like climbing stairs or carrying groceries
- Slower metabolism, making it harder to keep weight off
- Weaker bones and higher risk of falls
- Less energy for the activities you enjoy
The good news? Strength training can cut muscle loss in half or even prevent it almost entirely.[1] Exercise also helps you lose more belly fat, reduces inflammation, improves your heart health, and gives you more energy.[2]
Your Three-Step Exercise Plan
Step 1: Start Moving Gradually
You may feel more tired when you first start your GLP-1 medication, so it's okay to start slowly. Your goal is to work up to:
- 150 minutes per week of moderate activity (like brisk walking, swimming, or biking), OR
- 75 minutes per week of vigorous activity (like jogging, dancing, or aerobics)
What does "moderate activity" mean? You should be able to talk but not sing during the activity. You'll feel your heart beating faster and you'll breathe harder, but you won't be gasping for air.
Getting started:
- Week 1-2: Try 10-15 minutes of walking, 3-4 times per week
- Week 3-4: Increase to 20-25 minutes, 4-5 times per week
- Week 5-8: Build up to 30 minutes, 5 times per week
Step 2: Add Strength Training (This Is Essential!)
Strength training is not optional—it's the most important thing you can do to protect your muscle while losing weight.[1][2]
Your goal: At least 2-3 times per week, for 20-30 minutes each session
You don't need a gym! You can do strength training:
- At home with resistance bands (available online or at most stores)
- With dumbbells or household items (water bottles, canned goods)
- Using your own body weight (push-ups, squats, planks)
- At a community center or gym
- With online videos or apps
What exercises should you do?
Focus on exercises that work multiple muscle groups at once:
- Legs: Squats, lunges, step-ups
- Chest and arms: Push-ups (on knees if needed), chest press
- Back: Rows, pull-downs
- Core: Planks, bridges
- Shoulders: Overhead press, lateral raises
How much weight should you use?
- Start with a weight that feels challenging by the last 2-3 repetitions
- Aim for 8-12 repetitions per exercise
- Do 1-3 sets of each exercise
- Rest 1-2 minutes between sets
When you can easily do 12 repetitions for 2 workouts in a row, it's time to increase the weight slightly.
Step 3: Combine Both for Best Results
Once you're comfortable with both aerobic activity and strength training, your weekly routine might look like this:
- Monday: Strength training (30 minutes)
- Tuesday: Walking or other aerobic activity (30 minutes)
- Wednesday: Strength training (30 minutes)
- Thursday: Walking or other aerobic activity (30 minutes)
- Friday: Strength training (30 minutes)
- Saturday: Longer walk or active hobby (45-60 minutes)
- Sunday: Rest or gentle stretching
Managing Common Challenges
"I feel too tired to exercise"
- Fatigue is common when starting GLP-1 medications, especially during dose increases
- Exercise when your energy is highest (often morning or early afternoon)
- Start with just 5-10 minutes and gradually build up
- If fatigue is severe or doesn't improve, talk to your doctor
"I feel nauseous"
- Avoid exercising right after eating
- Stay well-hydrated before, during, and after exercise
- Start with gentle activities like walking
- Exercise intensity may need to be lower on days when you feel more nauseous
"I don't know how to strength train"
- Ask your doctor for a referral to a physical therapist or certified personal trainer
- Look for beginner strength training videos online (search "beginner resistance training")
- Many community centers offer low-cost group classes
- Start simple—even basic exercises are effective!
"I'm worried about getting hurt"
- Always warm up for 5 minutes before exercising (light walking, arm circles)
- Focus on proper form rather than heavy weights
- If something hurts (not just feels challenging), stop and adjust
- Cool down and stretch for 5 minutes after exercising
Eating Right to Support Your Exercise
While your GLP-1 medication reduces your appetite, it's important to eat enough—especially protein—to support your muscles.[2]
Protein is your muscle's best friend:
- Aim for 80-120 grams of protein per day (or about 1.2-1.6 grams per kilogram of your body weight)[2]
- Eat protein at every meal
- Eat your protein first at each meal to make sure you get enough[2]
Good protein sources:
- Greek yogurt, cottage cheese
- Eggs
- Fish and seafood
- Chicken and turkey
- Beans, lentils, and peas
- Nuts and nut butters (peanut butter, almond butter)
- Protein shakes or bars (if needed to meet your goals)
Important: Eating more protein alone won't protect your muscles—you must combine it with strength training![2]
Tracking Your Progress
Keep track of your success beyond just the number on the scale:
- Strength: Can you lift heavier weights? Do more repetitions?
- Endurance: Can you walk farther or faster without getting tired?
- Function: Are daily activities easier (climbing stairs, carrying groceries)?
- Energy: Do you have more energy throughout the day?
- Measurements: How do your clothes fit? What's your waist measurement?
When to Contact Your Doctor
Call your healthcare provider if you experience:
- Significant decrease in strength or ability to do daily activities
- Dizziness or lightheadedness during exercise
- Severe or persistent fatigue that prevents normal activities
- Any new or concerning symptoms
Remember: Exercise Is Medicine
Think of exercise as part of your treatment plan, just like your GLP-1 medication. The combination of medication plus exercise gives you:
- Better weight loss results (especially belly fat)[2]
- Preserved muscle and bone strength[2]
- Improved heart health and blood sugar control[2]
- More energy and better quality of life[3]
- Better long-term success in keeping weight off
Getting Started Today
You don't have to do everything perfectly right away. Here's how to start:
1. This week: Add 10-15 minutes of walking on 3 days
2. Next week: Try 2 simple strength exercises (like squats and wall push-ups) for 10 minutes, twice this week
3. Following weeks: Gradually add more time and exercises as you feel comfortable
Every bit of movement counts! Even small amounts of exercise are better than none, and you can build up gradually over time.
Resources to Help You
- Ask your doctor about referrals to physical therapy or exercise programs
- Check your local community center for exercise classes
- Look for "beginner strength training" or "resistance training for beginners" videos online
- Consider working with a certified personal trainer for a few sessions to learn proper form
- Many health insurance plans cover fitness programs—ask about benefits
You've got this! By combining your GLP-1 medication with regular exercise—especially strength training—you're setting yourself up for the best possible results. Your future self will thank you for taking care of your muscles today.
Disclaimer:
This content is for educational purposes only and is not intended as medical advice. Always consult your healthcare provider before beginning any exercise or weight-loss program.
References
Integrating Diet and Physical Activity When Prescribing GLP-1s—Lifestyle Factors Remain Crucial. Mehrtash F, Dushay J, Manson JE. JAMA Internal Medicine. 2025;:2836533. doi:10.1001/jamainternmed.2025.1794.
Nutritional Priorities to Support GLP-1 Therapy for Obesity: A Joint Advisory From the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society. Mozaffarian D, Agarwal M, Aggarwal M, et al. The American Journal of Clinical Nutrition. 2025;122(1):344-367. doi:10.1016/j.ajcnut.2025.04.023.
Physical Activity and Excess Body Weight and Adiposity for Adults. American College of Sports Medicine Consensus Statement. Jakicic JM, Apovian CM, Barr-Anderson DJ, et al. Medicine and Science in Sports and Exercise. 2024;56(10):2076-2091. doi:10.1249/MSS.0000000000003520.
