Everyone talks about it.
But how much of a problem is it, really?
And how do I avoid it?
Losing weight on GLP-1s is easy – deceptively easy. But without a diet that proritises protein and fibre and includes regular resistance training, you’re very likely be to storing up a bunch of problems for later. Whether you are naturally disciplined, get a buddy or a coach, i can’t emphasise strongly enough how important it is to make sure you absolutely do these two things.
You’ve probably heard people say that after stopping GLP-1 therapies, most people gain all their old weight back – and more. So just like the old calorie counting diets, right? Not quite.
It’s true that muscle loss is an inevitability when we lose weight – no matter how we do it. A rule of thumb is around 14-25% of weight loss will be ‘lean mass’ – but it is much more complex than this, really, depending on many factors like activity levels, metabolism, age, and many others. There is also some evidence that muscle loss is actually lower for people losing weight with GLP-1s compared with conventional calorie restriction – can be seen as ‘protective’ against muscle loss … read on to find out more.
Why is muscle loss a problem anyway?
Muscle is a ‘metabolically active’ tissue, meaning that it burns calories just sitting there doing nothing! [and of course burns much more if used]. If you lose muscle, your metabolic rate [the amount of calories you burn at rest] drops, so you have to eat less than before to maintain the same weight. It’s one of the main reasons why people who lose weight gain more of it back once they stop the diet [any weight-loss diet].
In middle aged and older adults, it can also put you at risk of sarcopenia (weak, fatty muscle) – and frailty. Our muscles protect us in so many ways – not least protecting our joints and keeping us physically stable.
Healthy aging means working harder to maintain our muscles throughout life – and actually prioritising it more as we get older. It’s ironic that the usual saying of “I do less now I’m older” really needs to be the opposite if we want to maximise our healthspan.
So, how can we minimise muscle loss when on GLP-1 therapies?
In short, two things:
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- Prioritise protein [diet]
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- Resistance training [activity]
How resistance training helps
Several scientific studies have shown that strength-based workouts [ones that use all major muscle groups] strongly reduce the amount of muscle that is lost with diet or GLP-1 weight loss, especially in middle aged and older people (see here, here and here).
There is even some evidence that GLP-1 therapies might have particular effects that help us to hold on to more muscle.
Bottom line: Resistance [strength] training is non-negotiable when on GLP-1s!
I am really, really unfit! Where do I start?
My favourite for absolute beginners is Joe Wicks 10 minute workout. If changing into workout clothes is a barrier for you, then this workout is perfect as you can even do it in your jeans [well, I do] – I figure, better to do something in jeans than do nothing!
If you have more time, you could try this 20 minute, whole body workout. It’s a good one, and I love the fact that ‘FabFitFifty+’ is working out in her kitchen. So wonderfully relatable!
[For those of you more advanced with your fitness, you’ll no doubt have your own favourites and routines.]
Alternatively, you can create your own weight training workout, which science tells us should aim for 1-3 sets of 8-12 repetitions per set, making sure you target all the major muscle groups.
Sticking to it when you’re tired
Fatigue and general tiredness is a really common side effect of GLP-1 therapies, and can make it super hard to motivate yourself to exercise, and days/weeks can slip by, all the time we’re losing muscle…
Yet it is so important! If you have trouble sticking to an exercise regime, then consider getting some ‘external accountability’ [like a buddy or a GLP-1 coach]. Having someone you have to ‘show up’ for can make all the difference!
What about diet – and prioritising protein?
Super, super important! Too much to cover here so I’ve put it in another blog post – see here.