There’s simply no denying that glucagon-like peptide 1 (GLP-1) agonist medications have revolutionized the treatment of type 2 diabetes and obesity. These drugs mimic the naturally occurring GLP-1 hormone in our body that’s released from the gastrointestinal system after we eat, increasing insulin production from our pancreas crucial for regulating blood sugar (glucose) levels, as well as reducing appetite. GLP-1 drugs also reduce glucagon, a hormone that raises blood sugar, by liberating it from glycogen stores in our muscles and liver.
If you’re taking a GLP-1 medication, whether it’s to manage your blood sugar or help you lose weight, you should be maximizing its effects with exercise. Not only does physical activity help further promote weight loss, but it also improves body composition by preserving lean muscle mass.
“What we have seen clinically for many clients that come to us on a GLP-1 without modifying their diet and exercise is that they tend to lose muscle at a more rapid pace,” explains Jerry Bailey, D.C., LA.c., a certified nutritionist, acupuncturist, chiropractor and functional medicine physician with Lakeside Holistic Health. “The fat mass lingers longer while the lean mass decreases, in turn slowing the metabolism down.” Similarly, research shows that people often have a slower metabolism when they go off GLP-1 medications than before they started taking them, which contributes to weight regain.
While GLP-1s can significantly aid weight loss and improve glycemic control, relying on them alone can be a disservice to your overall health, Bailey warns. “Eating well and exercising regularly provide benefits that medications alone cannot offer,” he says. “A nutritious diet rich in whole foods not only helps with weight management but also delivers essential nutrients that promote optimal bodily functions and improve energy levels. Regular physical activity, on the other hand, strengthens the cardiovascular system, enhances muscle tone, and boosts mood through the release of endorphins.”
Generally, exercise should be considered a must-do for people taking GLP-1 medications. And, done right, a movement routine will only enhance the effects of the drug. So, what should you keep in mind when getting sweaty if a GLP-1 is a part of your health routine? Here, experts break down a few must-know tips for maximizing your weight loss and blood sugar benefits.
- ABOUT OUR EXPERTS: Roger E. Adams, Ph.D., is a doctor of nutrition and owner of eatrightfitness. Jerry Bailey, D.C., LA.c., is a certified nutritionist, acupuncturist, chiropractor, and functional medicine physician with Lakeside Holistic Health. Beverly Tchang, M.D., is an obesity endocrinologist and advisor for Ro.
1. Make sure you’re fueling with enough protein
Since GLP-1 medications suppress appetite, you want to make sure you’re fueling your body to the best of your ability with high-quality foods before and after your workouts. “Reduced caloric intake, as well as reduced nutrients, can impact your energy levels and muscle recovery after workouts,” explains Roger E. Adams, Ph.D., doctor of nutrition and owner of eatrightfitness. Eating a balance of protein, healthy fats, and complex carbohydrates—particularly around exercise—will keep your energy and recovery in good standing.
That’s not your only move, though. “Protein intake, in particular, is critical when using GLP-1s for weight loss,” Adams says. “Without adequate amounts, your body may start breaking down muscle mass to meet its needs which can lead to increased risk of injury, a slower metabolism, and reduced functional ability,” he says. Experts often recommend people taking GLP-1s consume between 1.2 and two grams of protein per kilogram of body weight per day to protect muscle mass and a healthy metabolism. (That comes out to 109 to 181 grams of protein per day for someone who weighs 200 pounds.)
Read More: 9 Easy Ways To Increase Your Protein Intake
If you struggle to get enough protein down the hatch, Adams recommends supplementing with protein shakes or powders.
2. Be extra conscious of hydration
Staying hydrated is always important, especially when exercising, since sweating further dehydrates you. But it’s worth noting that GLP-1s suppress your ability to sense thirst, meaning a person can pretty much go all day without drinking water and never feel thirsty, explains Beverly Tchang, M.D., an obesity endocrinologist and Ro advisor. As such, you’ll need to be extra intentional about drinking water instead of just relying on your instincts.
“The usual guidance is 64 ounces per day to avoid dehydration, which can manifest as fatigue or dizziness,” she says. “No one wants to do a workout feeling that way!” Of course, your hydration needs may vary based on factors like how much you sweat, so keep an eye on your urine (it should be light!) and other symptoms to ensure you’re in good standing. If you have a hard time downing plain water or staying on top of your hydration, consider adding a hydration supplement to your bottle.
3. Be Mindful Of your blood sugar levels
GLP-1 agonists can change how your body handles glucose, which could impact how you feel during workouts, warns Bailey. “Essentially, these medications help regulate your body’s sugar levels by slowing down the rate at which food empties from your stomach,” he explains. “This helps prevent spikes and crashes in blood sugar levels, which can cause feelings of fatigue and low energy that may impact your endurance when exercising.” He recommends monitoring your blood sugar levels before and after exercise to prevent hypoglycemia (a.k.a. low blood sugar), though it’s less likely to be an issue with GLP-1s than other diabetes medications.
“Regular tracking will help you understand how your body reacts to different types and intensities of exercise, allowing you to adjust meal times or medication doses accordingly,” says Bailey. He recommends timing a snack or small meal close to your workout to ensure you’ll have sugar in the tank to make it through. You might also keep a fast-acting carbohydrate source (like a banana or sports drink) handy during intense workouts, just in case an unexpected drop in blood sugar has you suddenly feeling weak or faint.
4. Choose workouts that build muscle mass
Since GLP-1 medications often cause people to lose a decent amount of muscle, strength training (think weightlifting, resistance band work, and the like) is especially important for those taking them. “These exercises can help maintain and build muscle mass, counteracting the potential reduction of lean body mass,” says Bailey. Strength training also stimulates bone growth and increases bone density, which can help prevent osteoporosis and other bone-related issues that GLP-1 use has been suggested to contribute to.
Read More: How To Maintain A Healthy Weight When Going Off GLP-1s
While cardio certainly has a place, Bailey recommends dialing down excess cardio because it can contribute to muscle loss (which is already enough of an issue on these medications). Balance any cardio you enjoy doing with strength training exercises that target all major muscle groups, he suggests. Aim for at least two to three strength sessions per week to support balanced muscle development and overall metabolism.
5. Tailor your routine to your energy levels
When taking a GLP-1 medication, you might notice some ups and downs in your energy levels. This is normal and due to appetite changes and/or gastrointestinal side effects, explains Bailey. He recommends listening to your body and tailoring your workout intensity accordingly. “High-intensity workouts—like circuit training, Tabata, spinning, bootcamp workouts, or HIIT—can be beneficial but require longer recovery periods to prevent fatigue or overtraining, so you should try to integrate both high-intensity sessions and lower-intensity activities like walking or yoga into your regime,” he says. “Adequate rest and recovery are key for preventing injuries and ensuring consistent progress in your fitness journey.” Give yourself the grace to adjust your workout plan based on how you’re feeling on a given day; your consistency over time is more important than squeezing in that extra sweat this week!
6. Be smart about supplements
Whether you regularly relied on performance supplements before starting a GLP-1 or want to try them out now to support a new workout routine, it’s essential to be mindful of how your medication use may influence their safety and/or efficacy. Pre-workout formulas that contain high levels of caffeine or stimulants may pose risks, according to Bailey. “These can exacerbate potential side effects of GLP-1 agonists, like increasing heart rate or gastrointestinal discomfort, and should be used cautiously or avoided,” he says.
To minimize the risk of unwanted side effects, start with small amounts of these pre-workout powerhouses (even if you used higher doses before starting a GLP-1). For example, Bailey recommends limiting caffeine intake to 50 to 100 milligrams per day to gauge how you feel. You may also find you need to be more careful about avoiding certain ingredients, like stimulants, on an empty stomach, as downing them without any food in the tank can worsen GI symptoms often experienced on these medications.