GLP-1 and exercise
Losing weight quickly on a GLP-1 medication can also mean losing muscle and bone. Strength training helps protect both. Our Accredited Exercise Physiologists build that program with you across Footscray, Port Melbourne and Glen Iris, and by telehealth.
GLP-1 medications are prescription medicines. Semaglutide and tirzepatide are two examples. Your doctor decides whether one is right for you, the dose, and how long you take it. Our work starts once that decision is made.
Australian guidance is clear that these medications are meant to sit alongside changes to eating and physical activity, not replace them (Exercise & Sports Science Australia [ESSA], 2026). ESSA also recommends that anyone prescribed weight loss medication has access to an Accredited Exercise Physiologist at the same time (ESSA, 2026).
Fast weight loss changes more than the number on the scales. Some of what comes off is muscle and bone, and the right training protects them. Here is what the research says, and what we do about it.
Muscle and bone do not come off gently when weight drops fast. Here is what the studies found, and what strength training does about it.
Across 22 trials of GLP-1 medications, about a quarter of the weight lost was lean tissue rather than fat (Karakasis et al., 2025). Some studies found 15% or less, others 40% or more (Neeland et al., 2024). Lose 15 kg and 3 to 4 kg of it could be lean tissue. Lean tissue includes muscle, along with water and organs.
In a one year weight loss trial, people who exercised kept their hip and spine bone density better than people who did not (Jensen et al., 2024). Progressive strength training helps limit bone loss during weight loss (Jiang & Villareal, 2025). Bone responds to load, and lifting is load.
Carrying the shopping, climbing stairs, getting up off the floor. These depend on strength, not on a number. With age, strength is lost faster than muscle size (Mitchell et al., 2012), so it needs its own attention while the weight comes off.
In older adults losing weight through diet, strength training prevented almost all of the muscle loss seen with diet alone (Sardeli et al., 2018). In another diet trial, people who lifted weights got 19% stronger and kept more bone at the hip than people who only did aerobic exercise (Villareal et al., 2017). Muscle is easier to keep than to rebuild.
You start where you are. Every program is built by an Accredited Exercise Physiologist and adjusted as your body changes. Here is what working with us looks like.
We look at your history, your strength, your joints and your confidence with exercise, and we ask how you are feeling on the medication. At Footscray, body composition tracking gives us a baseline to compare against later.
Two to three strength sessions a week built on big movements: squats, pushes, pulls and carries. The load goes up gradually as you get stronger. Australian guidelines recommend muscle-strengthening activity on at least two days a week (Department of Health, Disability and Ageing, 2026), and progressive strength training is one of the best supported ways to hold on to muscle and bone during weight loss (Jiang & Villareal, 2025).
Flat days happen, especially early on or after a dose change. Tell your prescriber about side effects, and tell us too. We adjust the session rather than skip it. Train one on one or in our supervised small groups. Supervised and group programs help people stick with exercise for longer (Rodrigues et al., 2026).
We retest your strength as the weight changes, with body composition tracking at Footscray, and adjust the plan. With your consent we keep your GP and dietitian in the loop, so everyone works to the same plan.
Strength training comes first, but it is not the whole picture. Aerobic exercise improves fitness while the weight comes off (Jiang & Villareal, 2025). Exercise also supports metabolic health and helps prevent weight regain (ESSA, 2026). Australian guidelines say be active on most days, and add muscle-strengthening on at least two days a week (Department of Health, Disability and Ageing, 2026).
Weight regain after any treatment stops is common. It usually follows an early loss and a plateau (Hall & Kahan, 2018). The strength, fitness and habits you build now carry you through changes to your medication. Structured exercise is linked with holding on to results after medication is reduced or stopped (ESSA, 2026).
A smaller appetite makes it harder to eat enough protein, which muscle needs. In one review, fewer than half of people on these medications met the usual protein target (Šantić et al., 2026). Your GP or a dietitian can set targets for you. Our part is the training that puts the protein to work.
Accredited Exercise Physiology across Footscray, Port Melbourne and Glen Iris, and by telehealth
Every one of our Accredited Exercise Physiologists works with people on GLP-1 medications, at all three clinics and by telehealth. This page was written by Cameron Tonkin, who has worked in chronic disease management since 2012, and reviewed by our Footscray clinic lead. Book with whichever clinic suits you.
Qualifications: Accredited Exercise Physiologists (ESSA) with Master of Clinical Exercise Physiology, Master of Clinical Exercise Rehabilitation or Graduate Diploma of Exercise Science degrees
Meet the teamNo referral is needed. This program is for people who:
Have just been prescribed a GLP-1 medication and want to start well
Have already lost weight and are worried about strength, energy or muscle
Are over 50, when muscle and bone are harder to get back
Have joint pain, an old injury, or a condition that makes exercise tricky
Feel unsure about gyms and want supervised support, with no judgement
Want support to keep moving well if their medical plan changes
Yes, and Australian guidance recommends it. Exercise is meant to sit alongside the medication, not wait until after it (ESSA, 2026). Start gently if you are new to training, build up over a few weeks, and tell your prescriber and your exercise physiologist how you are feeling on the medication.
Yes. Australian guidelines recommend muscle-strengthening activity on at least two days a week for every adult (Department of Health, Disability and Ageing, 2026). During fast weight loss it matters more, because some of the weight lost is lean tissue (Karakasis et al., 2025) and strength training is what protects it (Sardeli et al., 2018).
No. Muscle responds to training at any stage. Supervised strength training can improve strength and may build muscle, though results vary with age, health, nutrition and training history (Locatelli et al., 2024). Starting earlier is easier, but starting later still works.
Tell us, and tell your prescriber. Nausea and tiredness are common, especially after a dose change. We shorten or lighten the session rather than cancel it, so the habit stays. Your prescriber can also advise on managing side effects.
Two to three sessions a week of 30 to 45 minutes is a good target, using big movements and loads that get harder over time. That meets the Australian guideline of at least two days a week (Department of Health, Disability and Ageing, 2026). We build up to it gradually.
The scales may move a little less, because strength training helps you keep muscle while you lose fat (Villareal et al., 2017). We track strength and body composition, not weight alone.
Talk to your doctor before changing anything. Weight regain after any treatment is common, and it usually follows an early loss and a plateau (Hall & Kahan, 2018). Strength, fitness and habits can be maintained with ongoing training, but they need regular practice and review. Structured exercise is linked with holding on to results after medication is reduced or stopped (ESSA, 2026).
No. You can book directly with us. If your doctor has referred you or written a plan for you, bring the paperwork along and our admin team will talk you through your options.
Yes, for program planning, progressions and reviews. Strength testing needs an in-clinic visit, and body composition tracking is done at our Footscray clinic. Many people mix the two.
Your journey
Our supervised small group strength sessions run at all three clinics. Same programming, same coaching, a little more company. Supervised and group programs help people stick with exercise for longer (Rodrigues et al., 2026).
See small group trainingReady to start strength training on your GLP-1 medication? Book an initial assessment at Footscray, Port Melbourne or Glen Iris, or by telehealth. No referral needed.
Book Your First AppointmentAbout this page
Written by Cameron Tonkin, Accredited Exercise Physiologist (ESSA). Reviewed by Matthew Keech, Accredited Exercise Physiologist (ESSA), Footscray Clinic Lead. Last reviewed September 2026.
Department of Health, Disability and Ageing. (2026, June 3). Recommendations for adults (18 to 64 years). Australian Government. https://www.health.gov.au/topics/physical-activity/24-hour-movement-guidelines-for-all-australians/recommendations-for-adults-18-to-64-years
Exercise & Sports Science Australia. (2026, March 18). Policy position: Role of exercise physiology in the safe use of GLP-1 medications. https://www.essa.org.au/Web/Web/Resources/Publications/policy-position-on-role-of-exercise-physiology-in-glp-1-weight-loss-medications.aspx
Hall, K. D., & Kahan, S. (2018). Maintenance of lost weight and long-term management of obesity. Medical Clinics of North America, 102(1), 183-197. https://doi.org/10.1016/j.mcna.2017.08.012
Jensen, S. B. K., Sørensen, V., Sandsdal, R. M., Lehmann, E. W., Lundgren, J. R., Juhl, C. R., Janus, C., Ternhamar, T., Stallknecht, B. M., Holst, J. J., Jørgensen, N. R., Jensen, J. B., Madsbad, S., & Torekov, S. S. (2024). Bone health after exercise alone, GLP-1 receptor agonist treatment, or combination treatment: A secondary analysis of a randomized clinical trial. JAMA Network Open, 7(6), Article e2416775. https://doi.org/10.1001/jamanetworkopen.2024.16775
Jiang, B. C., & Villareal, D. T. (2025). The benefits of exercise training in combination with weight loss therapies. Diabetes, 74(12), 2199-2206. https://doi.org/10.2337/dbi25-0001
Karakasis, P., Patoulias, D., Fragakis, N., & Mantzoros, C. S. (2025). Effect of glucagon-like peptide-1 receptor agonists and co-agonists on body composition: Systematic review and network meta-analysis. Metabolism, 164, Article 156113. https://doi.org/10.1016/j.metabol.2024.156113
Locatelli, J. C., Costa, J. G., Haynes, A., Naylor, L. H., Fegan, P. G., Yeap, B. B., & Green, D. J. (2024). Incretin-based weight loss pharmacotherapy: Can resistance exercise optimize changes in body composition? Diabetes Care, 47(10), 1718-1730. https://doi.org/10.2337/dci23-0100
Mitchell, W. K., Williams, J., Atherton, P., Larvin, M., Lund, J., & Narici, M. (2012). Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength: A quantitative review. Frontiers in Physiology, 3, Article 260. https://doi.org/10.3389/fphys.2012.00260
Neeland, I. J., Linge, J., & Birkenfeld, A. L. (2024). Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies. Diabetes, Obesity and Metabolism, 26(Suppl. 4), 16-27. https://doi.org/10.1111/dom.15728
Rodrigues, M. S. A., Atanasio, L. M., dos Santos, I. K., da Silva, J. C. G., Cabral, B. G. A. T., & Dantas, P. M. S. (2026). Efficacy of interventions to promote exercise adherence in people with overweight or obesity: A systematic review. Journal of Obesity, 2026, Article 4164477. https://doi.org/10.1155/jobe/4164477
Šantić, R., Martinović, L., Pavlović, N., Rušić, D., Kumrić, M., Martinović, D., Tičinović Kurir, T., & Božić, J. (2026). Lean mass and musculoskeletal preservation in GLP-1-based obesity treatment: Nutrition, exercise, supplementation, and monitoring strategies. Metabolites, 16(6), Article 364. https://doi.org/10.3390/metabo16060364
Sardeli, A. V., Komatsu, T. R., Mori, M. A., Gáspari, A. F., & Chacon-Mikahil, M. P. T. (2018). Resistance training prevents muscle loss induced by caloric restriction in obese elderly individuals: A systematic review and meta-analysis. Nutrients, 10(4), Article 423. https://doi.org/10.3390/nu10040423
Villareal, D. T., Aguirre, L., Gurney, A. B., Waters, D. L., Sinacore, D. R., Colombo, E., Armamento-Villareal, R., & Qualls, C. (2017). Aerobic or resistance exercise, or both, in dieting obese older adults. New England Journal of Medicine, 376(20), 1943-1955. https://doi.org/10.1056/NEJMoa1616338
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