Do you also need to exercise if you lose weight with medication?

Exercise isn't compulsory to lose weight with medication, but it makes a significant difference to the quality of the weight loss. GLP-1 medication can help to eat less and lose weight, but without exercise there is a risk that some of the weight lost comes from muscle mass instead of fat mass. Exercise protects that muscle mass and improves long-term results.

This article answers the most frequently asked questions about exercising and losing weight with medication, from what the medication actually does to how much exercise is realistic.

What does waste medication do to your body exactly?

GLP-1 medication works by reducing feelings of hunger and prolonging the feeling of fullness. As a result, people eat fewer calories, which leads to a negative energy balance and weight loss. The medication also affects gastric emptying, causing food to be processed more slowly.

In concrete terms, this means that people who weight loss medication use, have less difficulty in restricting their food intake. The body takes in less energy than it expends, and as a result starts to tap into stored energy. That sounds simple, but the body makes choices in the process: it draws on both fat reserves and muscle tissue as an energy source.

This is precisely why exercise is relevant. Without sufficient physical activity, the body can break down a relatively large amount of muscle mass alongside fat. Results vary per person, but this pattern is a well-known point of concern during weight loss through calorie restriction.

Do you have to exercise to lose weight with medication?

No, exercising is not a strict condition for losing weight with GLP-1 medication. The medication works even without exercise. However, people who exercise during their treatment programme generally lose more fat mass, retain more muscle mass and have a better chance of maintaining the weight loss in the long term.

Losing weight without exercising is therefore possible, but the result is qualitatively different. Anyone who only watches the scales might see the same numbers. However, those who also pay attention to body composition, fitness and energy will notice that exercise makes a fundamental difference. Moreover, regular exercise helps to regulate blood sugar levels, which aligns with the effects of GLP-1 medication.

It is not a matter of someone training intensively every day. Even moderate, regular exercise has a positive effect on the outcomes of a weight-loss treatment programme.

What happens to your muscle mass if you do not exercise?

When someone loses weight by eating less without exercising, the body breaks down muscle tissue alongside fat. This is known as muscle breakdown or muscle loss. With a severe calorie deficit, a significant portion of the weight loss can come from muscle instead of fat.

Muscle loss has several disadvantages. Muscles burn more energy at rest than fat tissue. Less muscle mass therefore means a lower basal metabolic rate, as a result of which the body burns fewer calories. This makes it harder to maintain weight after stopping medication.

In addition, muscle mass affects strength, mobility and overall functioning. People who lose a lot of muscle mass during a weight-loss journey often feel weaker or more fatigued, even though their weight is dropping. Strength training or other forms of resistance training are the most effective way to limit muscle loss during weight loss.

Which type of exercise works best with weight-loss medication?

A combination of strength training and cardiovascular exercise yields the best results when losing weight with medication. Strength training protects muscle mass, while cardio increases energy expenditure and improves fitness. Both forms complement each other and do not need to be intense to have an effect.

Strength training for muscle maintenance

Resistance training, such as exercises with weights, resistance bands or your own body weight, gives the body a signal to maintain muscle tissue. Two to three times a week is already enough to make a noticeable difference. Think of squats, lunges, push-ups or exercises with light weights.

Cardio for fat burning and fitness

Walking, cycling, swimming or light jogging are accessible forms of cardio that are easy to combine with a busy schedule. Intense cardio sessions are not necessary. Regularly walking briskly, for example thirty minutes a day, already has a positive effect on energy expenditure and overall health.

How much exercise is enough when you are on medication?

The Dutch health guidelines recommend a minimum of 150 minutes of moderate physical activity per week, supplemented with muscle-strengthening activities twice a week. This is also a realistic starting point for people using GLP-1 medication for weight loss. More is better, but starting with less is better than not exercising at all.

For people who are not used to exercising much, it is advisable to build it up gradually. Starting with ten to fifteen minutes of walking a day and slowly expanding this is more effective than starting intensively right away and giving up. Consistency matters more than intensity, especially in the long run.

People with a busy work schedule can also integrate exercise into daily routines: take the stairs, go for a walk during the lunch break or do a short strength training session at home. Small adjustments to daily behaviour contribute to the overall physical activity pattern.

What if exercising is difficult due to medication side effects?

Side effects such as nausea, fatigue or a reduced appetite can make it difficult to exercise, especially in the initial stages of a treatment pathway. In that case, it is advisable to temporarily reduce the intensity and duration of exercise and to listen to your body.

Light activities such as walking or gentle cycling are often better tolerated than intensive training when someone is suffering from side effects. There is no need to push through when the body gives clear signals that it needs rest. As soon as the side effects subside, which is the case for many people after the first few weeks, the intensity can be gradually increased.

Anyone experiencing persistent symptoms that structurally hinder movement is best advised to discuss this with their attending physician. Adjusting the dosage or treatment plan can sometimes offer a solution. It is important not to decide this independently, but to do so in consultation.

How Wellumo helps with medically supervised weight loss

Wellumo offers an accessible pathway for people who want medical supervision for weight loss, including the assessment of whether GLP-1 medication may be appropriate. The programme is entirely online and is supervised by Dutch-registered (BIG) doctors.

• A digital medical questionnaire as a starting point for the intake
• Assessment by a doctor within 24 hours on working days
• Upon approval, a prescription will be drawn up and sent to the cooperating pharmacy.
• Discreet delivery of medication, with an optional subscription for repeat deliveries
• Transparent pricing information beforehand, with no hidden costs
• Not everyone is eligible: a doctor assesses on a case-by-case basis whether a treatment is medically sound

Do you want to know exactly how the process works? Read more on the page How Wellumo works of Contact us for questions. Results vary per person and a doctor always determines whether a treatment is appropriate.