You’ve probably heard about GLP-1 medications: Ozempic, Wegovy, Mounjaro, etc. – and how they’re turning the weight loss conversations upside down.
Let’s break down how they work, get you some info you might not get from the parties with a big financial interest in prescribing and selling these medications, and learn two key things that are especially important to do in the event of using GLP-1s.
🧬 What Are GLP-1s — and How Do They Work?
• GLP-1 stands for glucagon-like peptide-1, which is a hormone your gut naturally releases after meals to help regulate appetite, slow digestion, and assist in blood sugar control.
• Medications like semaglutide (Wegovy/Ozempic) or tirzepatide (Zepbound/Mounjaro) mimic that hormone, tricking your brain into feeling full sooner and reducing cravings.
• That’s why people often see dramatic weight loss initially. It’s from eating less because the appetite signal is dampened.
Seems great and easy so far. Let’s look a little deeper and make sure we’re aware of some potential drawbacks that come with GLP-1s.
⚠️ Reality 1: Weight Regain After Stopping GLP-1s
A recent systematic review and meta-analysis found that people who stop GLP-1s tend to regain a significant amount of the weight they lost once the medication is discontinued. And it happens surprisingly quickly.
• Participants taking semaglutide or tirzepatide regained weight after stopping treatment, roughly proportional to what they originally lost; on average ~21 lbs.
• This weight regain happened even when lifestyle factors were similar, pointing to the physiological rebound once the drug is removed.
• This happens because when you lose weight – with or without medication – your body fights back by increasing hunger hormones, lowering metabolic rate, and preserving energy as fat rather than muscle.
If you lose weight with the drug but haven’t learned and reinforced better eating habits, your body will tend to return to its prior weight once the drug leaves your system, and you’re just back to where you started right?
Not quite, unfortunately. It gets even trickier when we look at the weight that was lost (and regained) in terms of muscle versus fat…
⚠️ Reality 2: Muscle Loss
Most people equate weight loss with fat loss; but that’s not the full picture. Research shows a substantial portion of the weight lost on GLP-1 therapy is lean mass, including muscle. That matters because:
• Muscle is harder to build and takes longer to gain than fat. When weight comes back, such as after stopping GLP-1s, it often returns as fat instead of muscle. That’s a worse body composition than before you started.
• Muscle burns calories at rest. So, losing muscle slows your metabolism.
• Muscle is essential for long-term health because it also supports blood sugar control, joint stability, balance, and strength. All of which protect your independence, resilience, and ability to move well as you age. (not to mention looking toned)
• This happens because when your appetite is suppressed and protein and calorie levels are well below maintenance levels (causing rapid weight loss), and especially without a strength training stimulus, your body quickly breaks down muscle tissue to meet energy demands.
If your metabolism is slower and you have less lean tissue to burn calories, staying lean becomes even harder, creating a downward spiral effect.
🍎 What You Can Do To Mitigate
Either way you slice it, all roads lead back to strength training and learning good nutritional habits.
If you’re taking GLP-1s: strength training combined with learning how to consistently and sustainably ingrain high protein, whole foods into your life will:
• Give your body the stimulus needed to maintain muscle mass while losing weight
• Give your body the protein needed to maintain muscle mass while losing weight
• Give you a better chance to keep the weight off when you go off the GLP-1 by ending up with more muscle and lifestyle habits that will support your target body composition.
And if you’re NOT taking GLP-1s: strength training and building good nutrition habits still do all those things and help you slowly and steadily lose body fat (not muscle) all the way to your target body composition.
We see it in action every day/week/month/year at Reverb.
Our members who follow the process and do the work to change their habits, with the guidance and support of their coach, surrounded by peers on the same journey, steadily lose 1-2 pounds of body fat per week (often while gaining muscle) and reach their goal weight strong, fit, and healthy.
Whichever path you’re on, give us a shout if you need some help!
