Why You Need to Exercise While on Ozempic (From Trainers Who Work With GLP-1 Clients)

Bottom line: You need to exercise on Ozempic, specifically strength training, for two reasons. First, resistance training keeps burning calories after your workout ends, unlike cardio. Second, if you lose more than 30 pounds without strength training, your joints can become loose and unstable, leading to back, knee, and hip pain. The drug can get you there, but without building habits you'll gain it back.

Before we dive in: obviously we're not doctors, so we're staying within our scope. We're not touching dosage or whether this is good or bad for you. That's a doctor conversation. We're speaking from our viewpoint: exercise, nutrition, lifestyle.

To clarify: we both have many clients that are on or have been on not just Ozempic but various types of GLP-1s. This is speaking from experience.

Can I just take Ozempic without exercising or changing my diet?

You can, but you'll likely gain it all back.

Here's the thing with any medically assisted weight loss, whether that's GLP-1s, surgery, whatever: you still have to build the habits. Whether the medication speeds it up or not, you have to build them. If you don't build those habits while you're on it, you've wasted your time, your money, you've put your body through things (there are side effects, almost everyone has some), and then you're just going to gain it all right back because you never learned how to lose it. You just had something do it for you.

There's nothing mentally worse than losing 40 pounds and then it comes back. For people that's happened over and over, that constant yo-yo, the reason is they're doing a crash diet or trying to take a shortcut, and they're not truly making fundamental changes.

The drug can be a bit of a shortcut to get there quicker, but you still got to make those changes.

How much weight should I lose per week on Ozempic?

ScenarioExpected LossWith lifestyle changes1-3 lbs/weekDrug only, no changes~1 lb/weekMore than 100 lbs to loseStill maxes around 3 lbs/week

With my clients, most still fall between one to three pounds per week. Three is considered excessive if they weren't on a GLP-1, but that's about as fast as I've seen. Even clients with more than 100 pounds to lose, the fastest is 3 pounds a week.

If you're at a month in and you've lost 3 to 4 pounds, you're being a bit impatient. Which is fair. But that's actually pretty normal progress.

You could make no changes and the drug will probably get you there on its own, about a pound a week. But it's going to take you right back once you're off it.

Why is strength training important while on Ozempic?

When someone on a GLP-1 asks me this, my initial reaction: they need to incorporate strength training. If not on top of what they're already doing, at least twice a week.

The pushback is usually "I don't care about building muscle or getting strong, I just want to lose this weight." Totally fair. But there's a lot of different ways to resistance train, and the benefit for weight loss is:

It burns more calories over time than cardio

When we lift weights, our body continues burning calories even when you're sitting on the couch later that day. With cardio, you burn a larger amount during the session, but once that 45 minutes is over and you've burned say 100 calories, that's it. Minute 46, you're not burning any more.

With resistance training for 45 minutes, you might only burn 50 during the session, but then even an hour or two later, when you're back at your desk or relaxing, your body keeps burning. It just responds differently.

It prevents joint pain from rapid weight loss

There's also a safety reason, especially if you're on a weight loss drug to lose more than 30 pounds. I've seen this with clients who have that much to lose: if they've carried that weight for a long time, once they start losing, their joints are a little loose and unstable and they start having weird aches and pains.

Here's what happens: if you have enough weight in your midsection, it kind of splays your hips open. If you're not strength training, you're going to lose that belly fat (wonderful), but then your hips are still open, your body's like "what the hell is this," and you get back pain, knee pain, hip pain.

You probably know someone who lost a lot of weight and they're like "yeah but now I'm achy." That's why.

How do I add strength training to my Ozempic routine?

If you're already walking three to four times a week for 45 minutes each, you could scale back to 30 minutes per walk. That hour you already had, you just bought an extra hour basically. Take 15 minutes away from each day and put that into resistance training.

Or keep the same number of days and trade one, maybe two, out for strength training. There's a lot of different ways to do it, but it should be a part of it.