Taking a GLP-1? Strength training might be just what the Doctor ordered.
- 6 days ago
- 4 min read
Unless you've been living under a rock for the past couple of years, you'll have heard about GLP-1 medications: 'fat loss jabs' as they're more commonly known. In recent weeks we've even seen the arrival of the pill-form GLP-1 that is removing the final stigma around these medications, the needle.
When they first arrived, there was real worry in my industry that they'd put personal trainers out of business. Why pay a coach when a weekly injection does the work?
I've watched the whole thing play out, and at this point I am VERY confident that these worries in my industry couldn't be further from the truth. For the first time in my professional lifetime, GPs and doctors are, by necessity, and in big numbers, actively telling their patients to get into a gym and start lifting weights.
What the doctor used to say
Some context first. I know some fantastic GPs. I work with several as clients and count others as friends, and they deeply understand the value of strength training for longevity, for health, and for your independence and function through your forties, fifties and sixties. Just this year the UK chief medical officers health and physical activity guidelines, yet again, underline strength training and cardiovascular exercise as essential components of a healthy, active, and long life.
But over thirteen years in practice I've also had hundreds of clients who did the same thing. Bad back, sore neck, dodgy knee. First port of call, the GP. And the first recommendation, more often than not, was some version of: "Stop going to the gym. Stop lifting weights. Do some stretching. Go and see a physio. Back hurts when you deadlift? Better stop deadlifting".
I understand why. A ten-minute appointment leaves no time for a full assessment, and exercise prescription sits outside a GP's scope of practice, so caution is the safe default. But the side effect has been generations of patients leaving the surgery with a negative view of strength training. The sense that lifting weights is something risky, to be avoided the moment your body complains, and their fears have just been confirmed by the highest authority on health and wellness: their doctor.
Then the trial data landed
When people lose a significant amount of weight on GLP-1s, and to be clear, that's often very good for their health, the data shows they can also lose meaningful amounts of muscle, strength and bone mineral density. The 44% muscle headline that's been shared on social media and in news headlines, for various reasons, overstates things in my opinion, but the point remains.
Losing excess weight is a win. Losing the tissue that keeps you upright, mobile and steady into later life is not. Even in the here and now, without taking into account how you're going to look and feel in 10 or 20 years time, losing the very tissue that keeps you strong, fit, and active, isn't a good strategy.
So doctors now find themselves having to say, alongside the prescription: join a gym. Lift weights. Protect your muscle and your bones.
One GP I know very well has gone further. He's said that, ethically, he won't prescribe these medications unless he knows the person has what he calls the wraparound care. Proper nutrition and dietetic guidance, because food intake drops dramatically. And a realistic way to fit strength training into their routine, whether that's simply the space in the diary and the willingness to train, or a coach who builds the plan and guides them through it.
The honest bit
Significant calorie restriction changes how your body handles training. Recovery is slower. Bone mineral density becomes a consideration: stress fractures and bone injuries are a particular risk for women. Overuse injuries become more likely when you're under-fuelled. Combine that with the realistic possibility you're also not getting anywhere near enough micronutrient content in your diet, and you can easily put yourself in a fairly precarious situation.
None of that is a reason to avoid the gym. It's a reason to train with structure. Well-planned, progressive strength training, matched to your body, your history and your starting point. The risks are only slightly elevated. But the need for detail is elevated in exactly the same measure.
A generic programme off an app might be fine when everything else is stable. If you're on a GLP-1, in your forties or fifties, spending long days at a desk in Birmingham city centre, the margin for guesswork shrinks.
I'm optimistic. Hugely so. The information available today is better than ever. The medical options, GLP-1s, HRT for women, TRT for men, are better than ever. The quality of practitioners is better than ever. The level of education around health and fitness for people walking into a gym for the first time is higher than ever. For people in midlife, there has never been a better moment to change the trajectory of your health.
So if you're taking a GLP-1, or considering one: please, keep the weight loss. And protect the strength that makes it worth having.