Combining GLP-1 Medications with Exercise: A Guide

Combining GLP-1 medications with exercise can enhance weight loss while preserving muscle mass, improving metabolic health, and supporting long-term results. GLP-1 medications, such as semaglutide and tirzepatide, help regulate hunger and blood sugar levels, but up to 40% of weight lost may come from muscle. Adding exercise, especially strength training, reduces muscle loss, boosts fat burning, and improves overall well-being. Studies show that pairing these treatments with regular physical activity leads to better results than using either alone.

Key Takeaways:

• Muscle Preservation: Exercise helps counter muscle loss caused by GLP-1 medications, maintaining metabolism.
• Improved Fat Loss: Combining exercise increases fat loss percentages significantly.
• Heart and Metabolic Health: Joint strategies reduce abdominal fat, inflammation, and improve insulin sensitivity.
• Mental Health Benefits: Physical activity enhances mood, motivation, and long-term habit formation.
• Exercise Recommendations: Focus on aerobic activities (150–300 minutes/week), strength training (2–3 times/week), and flexibility exercises.

For Singaporeans, integrating these strategies into daily routines - like walking at East Coast Park or using community fitness corners - can make it easier to stay active. Always consult a doctor before starting any new plan, especially if you're managing diabetes or other health conditions.

Benefits of Combining GLP-1 Medications with Exercise

Better Fat Loss and Muscle Retention

When you pair GLP-1 medications with exercise, the results go beyond just weight loss - you can lose fat while holding on to muscle. Clinical trials back this up. For example, in the STEP‑1 trial, patients on semaglutide lost 9.7% of their lean mass and 19.3% of fat mass. Similarly, the SURMOUNT‑1 trial with tirzepatide showed that about 25% of the total weight loss came from lean muscle. However, when exercise, particularly resistance training, is added to the mix, the percentage of fat loss increases significantly. The BELIEVE Phase 2b trial, presented at the American Diabetes Association's 85th Scientific Sessions in June 2025, revealed that while semaglutide alone led to 71.8% of weight loss being fat, adding a muscle-preserving intervention bumped that figure up to 92.8%.

"These insights indicate that it is not only possible to achieve substantial fat loss, but also to preserve, or even enhance, lean mass in the process."
– Steven Heymsfield, MD, Professor, Pennington Biomedical Research Center

Why is this important? For every kilogramme of muscle lost, your resting energy expenditure drops by about 13 kcal/day, compared to just 4.5 kcal/day for each kilogramme of fat lost. This makes muscle preservation through exercise a key factor in maintaining long-term weight management.

Improved Heart and Metabolic Health

The benefits of combining exercise with GLP‑1 therapy extend beyond body composition. This combination can significantly improve cardiovascular and metabolic health. Take the S‑LiTE randomised trial, for instance, conducted between 2016 and 2019 at Hvidovre Hospital and the University of Copenhagen. In this study, 195 adults with obesity first lost weight through diet and were then split into four groups for a year. Those who combined exercise with 3.0 mg liraglutide reduced abdominal (android) fat by 6.1 percentage points - more than double the 2.8 percentage point reduction achieved with liraglutide alone. They also saw a 43% drop in hsCRP, a key inflammatory marker linked to heart disease.

Exercise also counters the slight increase in resting heart rate sometimes associated with GLP‑1 medications. On top of that, combining exercise with these treatments has been shown to deliver major metabolic benefits, including a reduction in metabolic syndrome severity. As noted in the New England Journal of Medicine:

"Only the combination strategy was associated with improvements in the glycated haemoglobin level, insulin sensitivity, and cardiorespiratory fitness."

Better Mental Health and Motivation

It’s not just your body that benefits from this combination - your mind does too. Exercise boosts mental wellbeing and helps sustain motivation, creating habits that last even after stopping medication. In the S‑LiTE trial, participants who combined GLP‑1 therapy with supervised exercise remained active for an average of 225 minutes per week a year after discontinuing treatments. In contrast, those who relied on medication alone only managed 30 minutes per week.

Exercise also supports a positive self-image and mental strength by preserving muscle and improving metabolism. On a chemical level, physical activity releases compounds like brain-derived neurotrophic factor (BDNF), which help regulate mood, improve cognitive function, and control appetite.

"Exercise can, therefore, counteract the self-perception of poor health that can accompany the regular use of medication."
– Katharina Gross and Christian Brinkmann, German Sport University Cologne

Group workouts can make this even more enjoyable by turning exercise into a social activity. This added layer of support makes it easier to stick with the routine over the long term.

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Choosing the Right Exercises for GLP-1 Users

For individuals using GLP-1 medications, picking the right types of exercise can enhance treatment results by promoting fat loss, maintaining muscle mass, and improving overall well-being.

Aerobic Activities for Fat Burning

Activities like brisk walking, swimming, and cycling are great choices for those on GLP-1 medications. These low-impact exercises improve cardiovascular health and encourage fat loss without putting too much stress on your joints. If you're dealing with side effects such as nausea or fatigue, these options allow you to stay active without overexerting yourself.

The goal is to aim for 150–300 minutes of moderate aerobic activity each week. Start with 20–30 minutes a day, ensuring you can still hold a conversation comfortably while exercising. It's more effective to spread these sessions across the week rather than doing them all at once.

Once you've established a routine, it's time to add strength training to the mix to help maintain muscle mass.

Strength Training for Muscle Preservation

Aerobic exercises are great for burning fat, but to keep your muscle mass intact during weight loss, strength training is essential. Resistance exercises play a vital role in this process. As Roberto Codella from Università degli Studi di Milano explains:

"Exercise, particularly resistance training, is crucial for preserving lean mass and functional health, especially during weight loss."

Aim for 2–3 strength training sessions each week, targeting all major muscle groups. You can use resistance bands, your own body weight, or light weights. Focus on 8 to 10 exercises, performing 8 to 12 repetitions for each, and make sure to rest each muscle group for at least two days between sessions. Over time, you can gradually increase the weight, number of repetitions, or session length as your strength improves.

Flexibility and Balance Exercises

Adding flexibility and balance exercises to your routine, like yoga, Pilates, or stretching, can improve joint mobility, posture, and stability. These are especially useful if you're experiencing muscle stiffness or a limited range of motion. Balance exercises, such as standing on one leg or practising tai chi, can also reduce the risk of falls, which may be a concern if rapid weight loss impacts bone density. Flexibility exercises can double as active recovery, helping your body adjust while managing any lingering side effects from your medication.

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How to Combine GLP-1 Medications with Exercise

Starting an exercise routine while on GLP-1 therapy doesn’t have to be overwhelming. The goal is to ease into it, allowing your body to adapt to both the medication and increased physical activity. Here’s how you can do it safely and effectively.

Step 1: Consult Your Doctor

Before diving into any exercise plan, it’s essential to consult your doctor. In Singapore, GLP-1 medications like semaglutide (Wegovy, Ozempic) and tirzepatide (Mounjaro) require a prescription, so medical oversight is crucial. Your doctor can evaluate your fitness level and check for any potential risks. If you’re managing Type 2 diabetes with insulin or medications like glipizide, extra care is needed since exercise can further lower blood sugar levels. For personalised advice, Trimly's doctors offer free unlimited follow-ups to help integrate physical activity into your weight loss plan.

Step 2: Set Realistic Goals

Don’t expect drastic changes overnight. Instead, aim for 150 to 300 minutes of moderate-intensity aerobic activity each week. That’s about 20 to 40 minutes a day, and you can break it into smaller 10-minute sessions if that’s more manageable. A simple way to gauge your intensity is the "talk test" - you should be able to speak in short sentences but not sing. A healthy weight loss target is typically 0.5 to 1 kg per week or about 10% of your body weight over six months. Setting achievable goals helps you maintain motivation without overexerting yourself.

Step 3: Create a Balanced Weekly Routine

A well-rounded exercise plan includes a mix of activities. Here’s a practical weekly framework that fits Singapore’s lifestyle and climate:

Incorporate strength training at least twice a week to work all major muscle groups. If you’re experiencing common GLP-1 side effects like nausea or bloating - especially during dose adjustments - scale down the intensity as needed. To beat the heat, consider mall walking in air-conditioned spaces or exercising during cooler hours in the morning or evening.

Once you’ve established a routine, consistency is key. Keep track of your progress to make adjustments as necessary.

Step 4: Monitor Progress and Adjust

Tracking your progress keeps you motivated and helps you identify when to tweak your routine. The Healthy 365 app from Singapore’s Health Promotion Board is a handy tool for logging workouts and monitoring your activity. Pay close attention to how your body feels: if muscle soreness lasts more than 2–3 days, you may need to reduce the intensity or duration of your workouts. Be on the lookout for warning signs like tremors, rapid heartbeat, dizziness, or extreme fatigue, and stop exercising immediately if they occur. For those managing diabetes, always keep a small, sugar-containing snack on hand to prevent hypoglycaemia during workouts.

As your fitness improves, gradually increase one variable at a time - whether it’s speed, resistance, or duration - to keep challenging your body without overdoing it.

Supporting Your Exercise Routine with Nutrition and Recovery

Maximise your workouts while on GLP-1 medications by focusing on proper nutrition and recovery. These medications slow digestion and reduce appetite, which can make it tricky to fuel your body adequately. To stay on track, prioritise lean protein and nutrient-packed meals to support your workouts and maintain muscle mass.

Fueling Your Workouts

Protein plays a key role when you're on GLP-1 medications. Studies show that these treatments can lead to a 15–20% reduction in total body weight. Without enough protein, you risk losing muscle along with fat. To counter this, aim for 1.2 to 1.6g of protein per kilogram of your ideal body weight daily. For example, if your ideal weight is 65 kg, you should consume about 78–104g of protein each day.

Before exercising, have a light, balanced meal about 1–2 hours in advance. Something like wholegrain toast with peanut butter works well. After your workout, refuel within an hour by combining protein and carbohydrates. A good option could be grilled chicken with vegetables or an egg omelette on toast.

Steer clear of greasy, fried, overly sweet, or spicy foods around your workout times. If you’re struggling with appetite due to GLP-1’s effects, consider alternatives like high-quality protein shakes or Greek yoghurt to hit your protein goals without feeling overly full.

"GLP-1 therapy should not be viewed in isolation but rather as an adjunct to comprehensive, evidence-based nutritional and lifestyle management." – Dr Raj Dasgupta, Chief Medical Advisor at Garage Gym Reviews

Don’t overlook hydration and recovery - they’re just as crucial as your diet.

Hydration and Recovery

GLP-1 medications can dull your sense of thirst, increasing the risk of dehydration - especially in Singapore’s humid weather. Make it a habit to drink 2–3 litres of fluids daily and sip water consistently throughout the day to stay hydrated.

"People on GLP-1 medications can struggle to drink enough water, which just exacerbates side effects like nausea on these medications." – Dr Alexandra Sowa, Founder of SoWell

Getting enough sleep is essential for muscle repair and overall recovery after exercise. To prevent stiffness, spend 5–10 minutes stretching or using a foam roller after workouts. On days when you feel particularly tired - like during dose adjustments - choose active recovery activities such as light walking or swimming. If muscle soreness lingers for more than 2–3 days, consider scaling back the intensity of your workouts. For those managing diabetes, always keep a small snack on hand during exercise to avoid low blood sugar episodes.

Conclusion

GLP-1 medications on their own can lead to up to 40% muscle loss, potentially slowing metabolism and increasing the likelihood of regaining weight quickly. Studies indicate that without lasting lifestyle changes, individuals may regain as much as two-thirds of the weight they lost within a year of stopping the medication .

A combined approach, however, offers benefits that surpass what either method achieves alone. For instance, the S‑LiTE trial demonstrated that pairing exercise with liraglutide resulted in significantly greater reductions in weight and body fat compared to using either strategy independently. Notably, only the combination group saw improvements in both cardiorespiratory fitness and insulin sensitivity.

"Future obesity management is likely to prioritise integrated approaches that combine pharmacotherapy with lifestyle interventions, rather than replacing lifestyle changes with medication alone." – Roberto Codella, Department of Biomedical Sciences for Health, Università degli Studi di Milano

These insights highlight the importance of a well-rounded strategy. Professional guidance plays a crucial role in implementing this approach safely and effectively. Doctor-led programmes can assist with adjusting medication doses, managing potential side effects, and creating exercise plans tailored to your fitness level and health needs. For instance, Trimly offers MOH-approved, personalised weight loss programmes that combine GLP-1 medications (available in oral and injectable forms) with ongoing medical support. Everything is handled online, including free unlimited follow-ups and medication delivery straight to your doorstep.

FAQs

Can exercise help maintain muscle while using GLP-1 medications?

Yes, adding strength training to your routine is a great way to preserve muscle mass while taking GLP-1 medications. These medications are effective for weight loss by curbing appetite, but a significant calorie reduction can sometimes lead to muscle loss.

Incorporating resistance exercises, like weightlifting or bodyweight workouts, helps stimulate muscle protein synthesis, which is essential for maintaining lean muscle. Plus, regular exercise not only supports fat loss but also boosts overall fitness and complements the benefits of GLP-1 medications. Combining these medications with an active lifestyle creates a more balanced and sustainable path to reaching your health goals.

What types of exercises work best with GLP-1 medications?

Incorporating a variety of exercises can make GLP-1 medications work more effectively. Moderate-intensity aerobic activities, such as brisk walking (covering 1 km in 10–15 minutes), cycling on flat terrain, recreational badminton, or leisure swimming, are great options. These activities not only burn calories but also help maintain stable blood sugar levels. Aim for a total of 150–300 minutes of such exercises spread throughout the week.

Strength training plays a key role in preserving muscle mass and supporting long-term weight control. You can include body-weight exercises like squats, lunges, or push-ups, or use tools like resistance bands, free weights, or gym machines. Focus on engaging all major muscle groups at least twice a week.

Adding flexibility and balance exercises, such as yoga or dynamic stretches, can enhance mobility and lower the risk of injuries. This is particularly helpful if you experience side effects like nausea or dizziness. Trimly’s doctor-led plans can customise these exercise recommendations, ensuring they align with your needs and help you exercise safely while maximising the benefits of your GLP-1 therapy.

Why should I consult a doctor before starting an exercise routine while on GLP-1 medications?

Before starting any exercise routine while on GLP-1 medications, it’s crucial to consult a doctor. These medications can influence blood sugar levels, appetite, and cardiovascular health, so having professional advice ensures these changes are monitored and managed safely.

For those with conditions like diabetes, exercising without proper guidance could lead to complications such as hypoglycaemia or aggravate existing issues with the eyes, kidneys, nerves, or heart. A doctor can create a tailored plan that complements your treatment and health objectives, helping you achieve weight loss safely and effectively.

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