On GLP-1 Medications? How to Train to Preserve Muscle and Strength

GLP-1 medications such as Ozempic, Wegovy, and Mounjaro are becoming increasingly common for weight loss. While opinions on these drugs vary, one physiological reality remains consistent: rapid weight loss often comes with significant muscle loss.

Research on calorie restriction and pharmacological weight loss shows that 20-40% of total weight lost can come from lean mass, not just body fat. Muscle is more than aesthetic - it plays a key role in metabolism, joint health, bone density, strength, and long-term independence. Losing it can leave individuals lighter on the scale, but weaker, softer, and metabolically worse off.

This is why exercise during weight loss - especially when appetite and caloric intake are reduced - is not optional. Walking alone is not enough. Light activity alone is not enough. The body must be given a reason to preserve muscle tissue.

That reason is resistance training.

The Non-Negotiables for Muscle Preservation on GLP-1 Medications

Two factors are consistently supported by research when it comes to maintaining muscle during weight loss:

1. Progressive resistance training

2. Adequate protein intake

Focusing on training, the minimum effective dose for preserving lean mass is:

• 2-4 strength training sessions per week

• Full-body routines or upper/lower splits

• Emphasis on compound movements such as:

  • Squats or leg presses

  • Hip hinges (deadlifts, hip thrusts)

  • Rows

  • Presses

  • Lunges or step-ups

Each session should include:

• 3-5 primary movements

• 2-4 sets per exercise

• Moderate to challenging effort

The goal is not exhaustion - it is stimulation. Strength training provides a biological signal to the body that muscle tissue is still needed. On GLP-1 medications, energy intake and appetite are often reduced. For this reason, training should be:

• Efficient (45-60 minutes)

• Focused on quality over volume

• Built around adequate recovery

Rather than chasing maximal performance, the priority becomes maintaining strength and tissue.

How Often Should You Train?

For most individuals using GLP-1 medications:

• 2 days per week is the minimum needed to maintain muscle

• 3 days per week offers an ideal balance between stimulus and recovery

• 4 days per week is appropriate for those with a training background and strong recovery capacity

If fatigue is high, reducing volume is more effective than reducing frequency. Two focused strength sessions provide more benefit than frequent low-intensity cardio alone.

Warning Signs of Excessive Muscle Loss

Indicators that lean mass may be declining too quickly include:

• Rapid drops in strength

• A “frail” or flat appearance

• Persistent soreness or joint discomfort

• Fast weight loss without visible body composition improvement

• Development of a “skinny-fat” look

Weight loss that compromises strength and physical capacity is not a long-term success.

GLP-1 use is a personal and medical decision. However, individuals who choose this path deserve strategies that protect their health and function. Fat loss should improve capability, not diminish it.

Preserving muscle requires intention. Strength training is not optional - it is foundational.

The goal is not simply to be lighter.The goal is to be stronger in a smaller body.