Health & Exercise Forum

Weight Training and Aerobic Exercise for GLP-1 Users

The popularity of glucagon-like peptide-1 (GLP-1) medications, such as semaglutide (Ozempic, Wegovy, Mounjaro) for weight loss, have increased exponentially over the past few years. Many medical experts predict that it is only the beginning. Medicare recently announced that it will begin a pilot program for those who qualify for GLP-1. If approved and covered by Medicare, GLP-1 use will become widespread. While the potential benefits of these weight-loss drugs exceed the risk for those suffering from obesity, it is not without some risk and side effects such as gastrointestinal problems and loss of muscle mass. Following a healthy diet and engaging in an exercise program to maximize the benefits and minimize the side effects from GLP-1 medications is necessary.

GLP-1

Glucagon-like peptide-1 (GLP-1) medications, when used for weight loss, reduce food cravings, increase fullness, slow digestion and control blood glucose. However, gastrointestinal (GI) side effects and maintaining muscle mass and energy levels are common concerns. These medications are designed to mimic the action of a natural hormone GLP-1, which is produced in the intestines after eating. This hormone regulates appetite, blood sugar levels and digestion. Ultimately, by slowing digestion, GLP-1 users feel fuller for longer periods of time.

A recent study published in Journal of the American Medical Association (JAMA) strongly recommends that people using GLP-1 medications eat more protein, consume smaller meals and snacks, avoid certain foods to reduce constipation, nausea and heartburn, stay hydrated, and engage in regular exercise including aerobic exercise and strength training to minimize muscle and bone loss.

Benefits of a Well-Designed Weight Training Program for GLP Users

• Increased Strength
• Prevent Loss of Muscle Mass & Bone Density
• Improved Performance in daily tasks and activities
• Improved Endurance
• Improved Injury Prevention
• Improved Mental Health
• Improved Overall Health & Wellness

Risks From Poorly Designed or Unsupervised Program

• Risk level increases if the program is not developed or supervised by a qualified professional for technique, safety, intensity and frequency
• Lower Back Pain – from poor technique and overload
• Muscle/Tendon Strain – from overuse and overload
• Tendonitis – from overuse and overload

How to Begin A Weight Training Program for GLP Users

• Primary Care/Family Physician – get medical clearance to make sure that you are not at risk, especially if you have medical issues such as heart disease, hypertension, diabetes.
• Orthopedic Physical Therapist – your doctor may think you would benefit from a few visits with an orthopedic PT to make sure your program is well-designed for your specific goals and your specific needs or activities (gardening, walking, golf, tennis)
•  Avoid Getting Competitive – it sets you up for injury! No Clean-Jerk, Overhead Press, Full Squats. Don’t compete to lift to your maximum. Make Exercise FUN!
• Technique
  • Slowly lift and lower weight 4 seconds up, 4 seconds down
  • Breath – inhale lifting weight up and exhale down
  • Never hold breath!
  • Exercise Major Muscle Groups
  • Upper body: shrugs, rows, lats, biceps, triceps, chest press, wrist curls – all with light dumbbells and bands to start
  • Lower Body: hip hike, leg extension, ham curl, step ups, 45 degree squat, calf raise – all light with sandbags and dumbbells to start
• Lift 3 times per week on alternating days – 30 to 45 minute sessions
  • Warm up
  • Cool down
  • Work upper body/lower body
  • Can alternate days for upper body and lower body
  • INCLUDE AEROBIC EXERCISE:
  • Can alternate days for weight lifting with aerobic exercise (elliptical, swim, walk, run, bike)
• Concentrate on low weights (5-10#)/high repetitions(10-15 times)
  • Once you master the technique add 1-2 # and 3-5 reps
  • Never advance weight or reps if you overstrain and compromise technique

**STOP:

• If you have pain
• If you get lightheaded or dizzy
• If you experience lower back pain or joint pain
• If you have muscle or joint pain that lasts more than 2 days

SOURCES: Journal of the American Medical Association, Trimrx.com, National Institutes of Health 

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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!