Ozempic and exercise: how to maintain muscle on a GLP-1

If you’re taking a GLP-1 medication like Ozempic (semaglutide), whether for diabetes management or other health reasons, you may notice weight loss as a result — which can include loss of muscle as well as fat. In fact, research shows that up to 39% of the total weight lost on GLP-1 agonists like Ozempic can come from muscle mass. Because maintaining muscle is essential for a healthy metabolism, longevity, and daily strength, it’s important to know how to protect and maintain muscle while on these medications.

Below, Hinge Health physical therapists explain why Ozempic and exercise together are important for maintaining muscle while taking GLP-1s, so you can feel strong in your daily life.

Should you exercise while taking Ozempic?

Yes, you should exercise while taking Ozempic. “Staying active is one of the best things you can do for your overall health while taking GLP-1 agonists like Ozempic,” says Mary Kimbrough,  PT, DPT, a Hinge Health physical therapist. Research shows that regular movement not only helps you maintain muscle mass, strength, and metabolic health, but also boosts the effectiveness of the medication long-term.

A recent clinical study found that people who exercised while taking medications like Ozempic were more likely to keep weight off and regained less weight if they eventually stopped the medication, compared to those who didn’t exercise. This is likely because exercise revs your metabolism and helps you maintain calorie-burn even when you’re off GLP-1s. 

While there are no special rules for Ozempic and working out, following the general guidelines from the American College of Sports Medicine is a great place to start:

• Aim for at least 150 minutes of moderate-intensity aerobic activity (like brisk walking) each week. This can be split into 30 minutes most days, or break up your workouts into 10-minute increments, three times daily. 

• Perform strength or resistance training that targets all major muscle groups, at least twice a week to maintain muscle mass.

It’s safe for most people to be active on a GLP-1, but if you notice stomach side effects like nausea or diarrhea, it might feel harder to work out while taking Ozempic. If these symptoms don’t improve or if they get in the way of moving your body, reach out to your doctor for support.

Why exercise matters for people taking Ozempic

Establishing a consistent workout routine is one of the best ways to support your health and get the most benefit from taking a GLP-1 like Ozempic. “Exercise helps you maintain your muscle mass, supports blood sugar management, and promotes the strength your body needs for everyday activities, supports your heart health, and boosts your physical and mental well-being,” says Dr. Kimbrough. Here are the top reasons Ozempic and exercise should go together:

• Preserves muscle. Studies show that Ozempic and other GLP-1 medications can lead to muscle loss along with fat loss. “While it’s normal to lose some muscle when you lose weight, keeping as much muscle as possible is important for your strength and daily activities,” says Dr. Kimbrough. Muscles are important for strength, balance, and endurance. People who lose muscle mass quickly on GLP-1s can experience side effects like Ozempic butt, or when once-full glutes appear deflated, saggy, or flat after weight loss. Effects like this can be minimized when you maintain your muscle mass as you lose fat.

• Boosts mood and energy. Exercise isn’t just good for your body — it’s also great for your mind. “Movement releases feel-good chemicals in the brain that help improve your mood and reduce stress,” says Dr. Kimbrough. One study found that all types of physical activity, from walking and strength training to yoga and Pilates, lowered the risk of depression. Staying active may also help ease some of the tiredness or low energy you might feel with medications like Ozempic.

• Helps with heart and metabolic health. “Exercise is one of the best things you can do for your heart,” says Dr. Kimbrough. Regular movement helps lower blood pressure, boost your good (HDL) cholesterol, and reduce unhealthy fats in your blood, like triglycerides, according to the National Institutes of Health (NIH). If you have type 2 diabetes or are at risk for it, staying active can also help you manage your blood sugar, which also supports your heart.

How to prevent muscle loss on Ozempic

It’s more than possible to prevent muscle loss while taking Ozempic or other GLP-1s. Staying consistent with resistance training, increasing your protein intake, and getting good sleep can all help you maintain your muscle mass, and in some cases, help you increase your muscle mass, says Dr. Kimbrough. 

• Do resistance training. Aim for at least two strength sessions per week to support muscle growth, says Dr. Kimbrough. Pairing several of the targeted exercises above can create a full-body workout. If they start to feel too easy, try adding in weights or increasing the challenge.

• Prioritize protein. Eating enough protein helps build and maintain muscle. Research suggests consuming 60-75 grams per day if you’re on GLP-1s like Ozempic can help prevent muscle loss. For reference, three ounces of chicken has about 21 grams of protein, and half a cup of cottage cheese has around 14 grams.

• Get consistent, quality rest. Your body repairs and rebuilds muscles while you sleep. Research shows that getting 7-8 hours of sleep each night is important for muscle health and recovery.

If weight loss is one of your health goals when taking a GLP-1 medication like Ozempic, aerobic exercise can help you achieve that. However, it’s equally important to establish a consistent resistance training routine to prevent muscle loss on Ozempic and maintain (or increase) strength. If you’re new to strength training, or getting back into it after a long break, the targeted exercises above are a great place to start. Dr. Kimrough recommends doing some (or all) of these moves — which target all your major muscle groups — at least twice a week. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Tips for working out while on Ozempic

Staying active while taking Ozempic can help you reach both your short-term and long-term health goals. A few helpful strategies include setting SMART goals, listening to your body as you move, and adding variety to your exercise routine. These tips can make it easier‌ — ‌and more enjoyable‌ — ‌to stay on track with your movement goals.

1. Set SMART goals

“It’s important to set clear fitness goals, especially if you’re new to exercise,” says Dr. Kimbrough. She suggests using the SMART goal strategy:

• Specific: Make your goal clear and well-defined.

• Measurable: Make sure you can track your progress.

• Achievable: Set a goal that’s realistic for you.

• Relevant: Choose a goal that fits your needs and priorities.

• Time-bound: Set a deadline to help keep you on track.

Research shows that people who set SMART goals are more likely to stick with their plan than those who set more vague and less intentional goals. “Instead of saying, ‘I want to exercise more,’ try setting a goal like, ‘I will walk for 30 minutes, five days a week, for the next month,’” says Dr. Kimbrough. “This way, your goal is specific, measurable, realistic, and time-bound.” Once you’ve met your first goal, you can build on your progress and set new ones.

2. Listen to your body

It’s normal to feel some mild discomfort when you start moving, especially if you’re new to exercise, says Dr. Kimbrough. “Most muscle soreness should subside within a day or two. If it lasts longer, consider taking more rest between workouts or lower the intensity of your workouts. Your goal is to find your movement sweet spot, which means exercising enough for it to feel challenging, but not so much that you overdo it.

Practicing mindfulness — like checking in with how your body feels during and after movement — can help you notice what’s working and when you may need to adjust your routine. This way, you can move in a way that feels good for your body.

3. Mix it up

Including a mix of strength, cardio, and mobility exercises in your routine can help you feel your best and achieve your goals, says Dr. Kimbrough. Not to mention, adding variety to your workouts can make exercising more fun. As you build up, aim for at least three days of cardio, two days of strength training, and add in mobility work — like yoga or Pilates — once a week.

When to see a doctor

If you find that it’s tough to exercise because of Ozempic-related side effects such as stomach upset, dizziness, or fatigue, talk to your doctor, Dr. Kimbrough says. You should also reach out if it seems like you’re losing weight faster than expected. Your healthcare provider can help you understand what rate of weight loss is appropriate for you based on your health history, medications, and personal goals, and can offer guidance to help you stay on track safely.

You should also let your doctor know right away if you experience any serious side effects, including but not limited to: 

• Severe stomach pain that doesn’t go away

• Changes in vision

• Signs of low blood sugar such as sweating, slurred speech, shakiness, or fast heartbeat

• Symptoms of a serious allergic reaction (swelling of your face, lips, tongue or throat, or trouble breathing)

• Yellow skin or eyes

• Clay-colored poop

PT tip: Don’t push through pain

If you notice intense muscle or joint discomfort that doesn’t go away during exercise, it’s important not to push through it, says Dr. Kimbrough. If you’re new to strength training, check in with a physical therapist ‌ — ‌ they can help you figure out what’s causing your pain and guide you in making safe adjustments to your routine so you can do resistance training with confidence. 

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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