Taking GLP-1s? Make Sure You Exercise

GLP-1s mainly help people living with Type 2 diabetes manage blood sugar levels. But some, like Wegovy®, can help treat obesity, too, by slowing your digestion and curbing food cravings.

But for these medications to work, exercise is essential.

Endocrinologist Anira Iqbal, MD, explains why exercise is important and which types of physical activity give you the most success when it comes to weight loss.

Recommended exercises when taking a GLP-1

Semaglutide and other GLP-1s can lead to rapid weight loss — and if you’re not careful, you could lose muscle, too. Exercise helps prevent muscle loss and boosts your metabolism so you can sustain weight loss over time.

“Once you start losing muscle mass, it becomes very difficult to gain it back,” says Dr. Iqbal. “A combination of strength training and aerobic exercises really makes sure that what you’re losing is mostly fatty tissue.”

When you’re exercising on GLP-1 medications, consider these types of exercises:

• Strength training: Resistance training, weightlifting and other body weight exercises, like push-ups, help preserve muscle mass and bone density, even as you lose weight. “As you get older — and especially if you’re a woman in post-menopause — building muscle is one of the only ways you can increase your basal metabolic rate (BMR),” says Dr. Iqbal. Your BMR is the number of calories your body burns to keep your organs working while at rest.
• Aerobic exercises: “Aerobic activities, like walking, running, cycling or swimming, support long-term weight management,” says Dr. Iqbal. “Combining these exercises with GLP-1s helps improve cardiorespiratory fitness, insulin sensitivity and glucose tolerance, more than these medications would be able to do on their own.”
• Plyometrics: Box jumps, burpees and other bodyweight exercises combine resistance training and aerobics all in one. The goal: to improve athletic performance and increase your power, speed and strength.
• Stretching and flexibility exercises: Activities like yoga, Pilates and a stretching routine help reduce stress while priming your muscles for growth. Stress is a leading contributor to weight gain, so working these exercises into your physical fitness routine can really pay off in the long term.

Example workout schedule

GLP-1s work best when you take a combined approach to exercise. That means varying the types of exercises you do. A variety also helps give different muscle groups time to recover while still building a consistent routine and making long-term progress.

“We recommend aiming for about 150 minutes of moderate intensity exercises or 75 minutes of vigorous exercise every week,” says Dr. Iqbal. “The intensity of your exercises depends mostly on how high your heart rate is.”

Here’s an example of a weekly exercise routine:

• Monday: Full-body strength training and light stretching
• Tuesday: Moderate-intensity cardio
• Wednesday: Flexibility and core exercises
• Thursday: Upper-body strength training and a short cardio session
• Friday: Lower-body strength training
• Saturday: Active recovery, like walking, hiking or yoga
• Sunday: Rest and recovery

“This is just one example of how you can switch up your routine. You should create a schedule that works best for you and your goals,” advises Dr. Iqbal. “Working with an exercise physiologist or athletic trainer can help you reach those goals.”

Important exercise considerations

Physical fitness can be overwhelming, especially if you’re just getting started. But it doesn’t have to be. If you’re taking a GLP-1 and trying to figure out the best way to exercise, here are a few extra tips to get you moving and keep you motivated.

Start off slow

During the first few weeks on a GLP-1, when you’re taking the lowest dose, start slow. Give yourself time to get used to exercising — and don’t overdo it.

“If you’re not used to doing a significant amount of exercise, try just 10 to 15 minutes a day of light activity, like walking or stationary cycling,” suggests Dr. Iqbal.

As your dose increases during week five and beyond, boost your activity level, too. Try gradually increasing your weights, reps and sets, or carve out a periodization schedule to track your progress over time.

“To preserve muscle and sustain weight loss, you want to gradually and progressively increase weight training, even if you stop taking a GLP-1 medication,” she adds. “The muscle you’ve gained will help continue your increased basal metabolic rate and eventually lead to a healthier overall lifestyle.”

Eat protein

Protein is the building block for muscle, so it’s important to work it into every meal, especially when you’re following an exercise routine. Dr. Iqbal notes that this may seem difficult to do at first because GLP-1s lessen hunger. So, work with a dietitian to figure out how much protein you need when you’re taking the medication.

“Protein is critical to preserving muscle mass during weight loss, so it’s important to prioritize protein and eat it first at every meal so you don’t get full before you have it,” she says.

Not sure where to start? Focus on nutrient-dense, high-protein foods like:

• Chicken
• Fish
• Eggs
• Greek yogurt
• Cottage cheese
• Beans, lentils and legumes

“Protein powders and shakes can also help when you’re eating smaller, more frequent meals while you’re on GLP-1s,” she continues. “Just make sure you’re intentional about the shakes and supplements you choose because a lot of them can come with additives.”

Drink water

GLP-1s can bring side effects like nausea or vomiting, especially early on. But drinking water and staying hydrated can help lessen some of these side effects. They also help support your body while you’re putting it through the stress of exercise.

“These medications can lead you to not feel as thirsty, so you have to remind yourself to hydrate well,” says Dr. Iqbal. “It may help to set an alarm on your phone so you’re drinking water throughout the day.”

Listen to your body

If you feel dizzy, nauseated or have trouble breathing, stop exercising and talk with your healthcare provider. Some of these symptoms may be related to low blood sugar.

“It’s important to recognize signs of low blood sugar when you’re starting these medications and when you’re exercising,” emphasizes Dr. Iqbal. “While you’re taking GLP-1s, you may need to adjust the dosing of other diabetes medications. You may also need more frequent monitoring of your blood sugars.”

Whether you have diabetes or not, it’s always important to listen to your body to avoid injury and maximize your results. Over time, the more you ease into physical fitness, the better you’re likely to feel.