What to Eat and How to Exercise on a GLP-1: A Health Coach’s Approach

GLP-1 Weight Loss, Part 2: Strength, Nourishment, Recovery, and Health Beyond the Scale

In Part 1 of this series, GLP-1 Weight Loss: Are We Still Talking About Health?, I spent a lot of time asking questions.

That probably surprised no one who knows me.

I wanted to know what happens beyond the number on the scale. What happens to muscle and strength? What happens when someone’s appetite becomes so quiet that eating enough becomes difficult? What happens to energy, recovery, movement, and someone’s relationship with her body while that body may be changing fairly quickly?

Those questions were not theoretical for me.

Medical Disclaimer: This article is for educational and informational purposes only and is not intended to diagnose, treat, cure, or prevent any medical condition or replace individualized medical care. GLP-1 medications are prescription medications and should be used under the care of a qualified healthcare professional. Nutrition and exercise needs vary based on medical history, medications, health status, and individual circumstances. Please discuss changes to your medication, nutrition, or exercise routine with your healthcare provider when appropriate.

I currently support several clients who have used or are on GLP-1–based medications as part of their weight-loss journey. My role is not to prescribe their medication, adjust their dosage, or decide whether they should continue taking it. Those decisions belong between my clients and their qualified medical providers.

What I can do is support the person living in the body that is changing. And that is what Part 2 is about. Because when one of my clients tells me she lost another few pounds, I care and we celebrate every win- big or small. The entire journey is a praise party. But then I ask more questions.

• How is your energy?
• How are your workouts feeling?
• Are you still getting stronger?
• How is your recovery?
• Are you eating enough to support what we’re asking your body to do?
• How are you feeling in your body?
• What can you do now that you could not do a few months ago?

The medication may be part of her health care. It is not the entirety of her health. There are other priorities to weight loss that we must consider. First, We Are Paying Attention to Strength. I wrote about this in Part 1 because I think the conversation about GLP-1 medications and “muscle loss” has gotten oversimplified. Weight loss is not automatically fat loss. But lean mass loss is not automatically the same thing as skeletal-muscle loss either. Those distinctions matter.

Why Preserving Muscle Matters During GLP-1 Weight Loss

A 2025 body-composition substudy of the SURMOUNT-1 trial used DXA scans to evaluate 160 participants who completed body-composition assessments at baseline and 72 weeks. Among those taking tirzepatide, body weight decreased by 21.3%, fat mass decreased by 33.9%, and lean mass decreased by 10.9%. When researchers looked at what made up the weight that had been lost, approximately 74% came from fat mass and 26% came from lean mass. Interestingly, that proportion was very similar to the placebo group, where approximately 75% of the weight lost was fat mass and 25% was lean mass (Look et al., 2025).

Put more simply, most of the weight lost was fat, but not all of it. About one-quarter of the weight lost was lean mass.

There is an important distinction here: lean mass is not the same thing as skeletal muscle. DXA-measured lean mass includes non-fat soft tissue and does not isolate skeletal muscle alone. So while lean tissue loss matters, saying, “A quarter of the weight you lose on a GLP-1 is muscle,” is not scientifically precise.

That distinction matters when we talk about someone losing 20, 30, or 50 pounds. A traditional scale can tell us that total body weight went down, but it cannot tell us what changed within that weight.

Body Composition vs. Body Weight on a GLP-1

This is one reason I do not look at weight loss alone when working with a client taking a GLP-1 medication—or, really, with any client.

Body composition gives us information that body weight alone cannot.

A traditional scale tells us how much someone weighs. A bioelectrical impedance scale goes a step further by estimating how that weight is distributed between things such as body fat and lean mass. Those estimates are not equivalent to a DXA scan, but when measurements are taken under reasonably consistent conditions, they can provide additional context over time.

A person can lose weight without every pound coming from the tissue we hoped to lose. That is why I am also paying attention to the factors that help support lean tissue during weight loss, including resistance training, adequate protein and nourishment, hydration, recovery, and changes in strength.

GLP-1 Weight Loss: Why I Measure More Than Pounds

Weight still matters. If someone’s medical treatment is intended to produce weight loss, of course body weight is going to be monitored. But it does not have to be the only measurement that tells us how someone is doing.

With my clients, I am also interested in:

• Strength
• Exercise performance
• Energy
• Recovery
• Mobility
• Cardiovascular capacity
• Consistency
• Body composition when useful and appropriately measured
• How everyday activities feel
• Whether adequate nourishment is possible
• How someone is relating to food
• How someone is relating to her changing body

For me, the larger question is not simply, How many pounds did she lose?

It is also: What happened to her strength, energy, nourishment, movement, and ability to function along the way?

Someone can reach a lower weight while becoming stronger, moving better, and remaining well nourished. Someone else can reach a similar number while feeling depleted, losing strength, and struggling to recover. The scale cannot distinguish between those outcomes.

I think our definition of health should.

GLP-1 Strength Training: Why Muscle Function Matters Too

And we also need to talk about function. A newer study has helped add another layer to this conversation. The SEMALEAN study followed people with obesity who were treated with semaglutide 2.4 mg for 12 months. Among the 106 participants who completed the study, lean mass initially decreased during the first seven months and then stabilized. At the same time, handgrip strength increased by an average of 4.5 kilograms at 12 months (Alissou et al., 2026).

In other words, people lost some lean tissue at first, but their strength did not necessarily decrease with it. By the end of the study, participants were actually able to grip harder than they could at the beginning. That matters because the amount of lean mass someone has and how well their body works are not exactly the same thing. A body-composition test can estimate how much lean tissue a person has. A strength test tells us something different: what that person can actually do with her body.

That does not mean semaglutide protects muscle. This was a prospective study rather than a randomized trial designed to prove that question. But it does remind us of something important:

Muscle mass and muscle function are related, but they are not identical measurements.

Someone can experience changes in body composition without experiencing those changes in exactly the same way functionally. Which is why I am not only asking what the scale says. I want to know what her body can do. So when I talk about preserving muscle during weight loss, I am not only thinking about a number on a body-composition report. I am also thinking about function. Can she lift? Is she able to carry groceries? Can she get up from the floor? Is climbing the stairs easier for her? Is she maintaining or gaining strength? Those things matter too.

Strength Training Has a Purpose Here

My client’s strength workouts are not punishment for taking medication. They are not something she has to do to “earn” her weight loss. And they are certainly not because taking a GLP-1 somehow means she is cheating and needs to compensate for it.

We strength train because strength matters.

Research outside of GLP-1 treatment has consistently shown that resistance training can help preserve lean mass during periods of caloric restriction. A systematic review and meta-analysis of adults with overweight or obesity found that resistance training was particularly effective for improving or preserving lean mass, including during weight-management interventions (Lopez et al., 2022).

GLP-1-specific clinical recommendations are beginning to reflect that larger body of evidence as well. A 2025 joint advisory from the American College of Lifestyle Medicine, American Society for Nutrition, Obesity Medicine Association, and The Obesity Society identifies resistance training, appropriate:

• nutrition
• physical activity
• sleep
• stress
• and other lifestyle factors as important parts of comprehensive GLP-1 care.

The advisory specifically raises preservation of muscle and bone as considerations during significant weight loss (Mozaffarian et al., 2025). So when I program resistance training for my client, I’m thinking beyond calories burned.

I’m thinking about her ability to:

✔️ Push
✔️ Pull
✔️ Squat
✔️ Carry
✔️ Get off the floor.
✔️ Climb stairs.
✔️ Maintain balance.
✔️ Glute strength, which affects her power and future independence.
✔️ Pick things up.
✔️ Travel.
✔️ Work.
✔️ Live independently as she gets older.

Those things don’t show up when you step on a scale. They still count.

GLP Weight Loss: Paying Attention to Nourishment

This has probably been one of the most noticeable differences in working with some clients using GLP-1 medications. Sometimes they simply are not very hungry. For someone who has spent years thinking about food constantly, that change can feel like relief. I understand why. But hunger becoming quieter does not mean the body’s nutrient requirements disappeared with it. This is one of the areas where the current medical literature has become increasingly clear.

The 2025 joint advisory on nutrition and GLP-1 therapy identifies low nutrient intake as a legitimate concern when appetite and total food intake decline substantially. It discusses adequate protein, micronutrients, dietary quality, hydration, and overall nutritional adequacy as part of supporting people using these medications (Mozaffarian et al., 2025).

Protein is part of that conversation, particularly because significant weight loss can include losses in lean tissue. But I also don’t want protein to become the next wellness obsession where everything else disappears. What you eat matters, and it’s so much more than a list of “good” and “bad” foods. Will discuss the power of nourishing yourself well in the part of this series but these truths remain:

• Carbohydrates still matter.
• Fats also matter.
• Fiber matters.
• Vitamins and minerals matter.
• Hydration matters.
• Food variety matters, which equals micronutrients, also known as vitamins and minerals
• And enough total nourishment matters.

The advisory notes that the standard adult Recommended Dietary Allowance (RDA) for protein is 0.8 grams per kilogram of body weight per day. During active weight loss, higher amounts, such as 1.2–1.6 grams per kilogram per day, have been proposed. But there is an important limitation: for people with obesity, there is not yet one universally accepted method for deciding which body weight should be used to calculate that number. Actual body weight, adjusted body weight, ideal body weight, and fat-free mass may all be considered in different circumstances (Mozaffarian et al., 2025).

That nuance matters to me for many reasons.

GLP-1 Nutrition: Are You Eating Enough?

It is one reason I do not believe everyone taking a GLP-1 should simply be handed the same protein number they saw on Instagram. You may have heard, “Just eat 30 grams of protein at every meal.” That may work well for some people, but for others, 30 grams per meal may not be enough to meet their total daily protein needs.

Protein needs are individual. Body size matters. Activity level is a factor. Age is a major determinant. The amount of weight someone is losing matters. Their overall food intake is very important. And medical conditions can change what is appropriate for that person. The joint advisory itself emphasizes individualized nutrition assessment rather than a single formula for everyone taking these medications.

God made us wonderfully and individually. That means what works well for one client may not be what another client needs.

This is also why I intentionally keep my client load small. I only have the capacity to give seven people this level of individualized attention at one time. A generalized meal plan or workout program may work beautifully for one person and leave another person struggling, because the people following those plans are not all starting from the same place. And sometimes my work with a client is not about figuring out how to make her eat less.

Sometimes the conversation is much simpler:

Are you eating enough?

Walking Still Counts Too

Strength is a priority for me, but strength isn’t the only kind of movement that matters. We walk. Because it helps us build cardiovascular capacity. Mobility isn’t an option. We move in ways that support everyday life. The same 2025 advisory recommends that GLP-1 treatment be accompanied by regular physical activity, including both resistance exercise and aerobic activity rather than medication functioning as a substitute for movement (Mozaffarian et al., 2025).

But I want to make an important distinction here too.

Movement isn’t included because the medication didn’t “work enough.” Movement has health benefits that exist independently of whether another pound is lost. That changes the purpose of the workout. A walk doesn’t have to become a way to erase lunch. Strength training session doesn’t have to become punishment for the scale not moving. Movement can support capacity, cardiovascular health, strength, mobility, confidence, and the simple experience of inhabiting a body that moves. That was true before GLP-1 medications existed. It remains true now. Nothing has changed other than now there is a powerful tool to help those who struggle with food fixation.

Why Recovery Matters During GLP-1 Weight Loss

This part is harder to put into a graph. A person may technically complete a workout and still not be recovering well from it. So I pay attention. In coaching, questions create awareness. We don’t make assumptions we get curious and collect information and guide our clients to something they can sustain.

• How did the last session feel?
• How sore are you?
• How is your energy today?
• How are you sleeping?
• Are your usual weights suddenly feeling unusually heavy?
• Are you progressing, maintaining, or consistently losing strength?
• How much are you actually eating?

Some of these questions become particularly relevant when appetite and food intake have changed substantially. I’m not interested in making someone complete a workout simply because it was written on a calendar. Training is an input. The body still has to recover from it. And sometimes the information the body gives us means the plan needs to reflect the body standing in front of us rather than the plan that looked perfect on paper.

The Unanswered Questions About GLP-1 Weight Loss

I want to be particularly careful here because GLP-1 content online often moves faster than the science. We do have substantial research showing that resistance training helps preserve lean tissue during weight loss generally. There are emerging studies measuring body composition in people using semaglutide and tirzepatide. The expert recommendations encouraging resistance training and adequate nutrition during GLP-1 treatment.

What we do not yet have is decades of research telling us the exact exercise and nutrition prescription that will optimally preserve skeletal muscle for every person taking every GLP-1–based medication. An international expert consensus published for 2026 acknowledged this directly. The authors developed practical nutrition and lifestyle recommendations for people using GLP-1–based therapies. At the same time, they made an important distinction: many of those recommendations are not yet based on studies conducted specifically in people taking GLP-1 medications. Instead, some of the guidance is drawn from what we already know about nutrition, exercise, and weight management more broadly.

In other words, experts can offer useful guidance based on the best evidence currently available, but there are still important gaps in GLP-1-specific research (Sievenpiper et al., 2026). That is important. There are things we know. Information the evidence strongly supports. And there are still questions being studied.

We don’t have to pretend otherwise.

The Medication Isn’t the Center of Our Work

his may be what I keep coming back to most. When I work with someone who is taking a GLP-1 medication, I am not coaching a medication. I’m working with a person. My clients are women who have a life. They have a history with food. There relationship with their body or lack thereof has been a challenge. Many of them struggle with:

• Responsibilities.
• Stress.
• Sleep.
• Strength.
• Goals.
• Faith.
• Emotions.
• People she loves.

I truly beieve our bodies are brilliant. God made them “good”; He even said they were “good”. My clients bodies have carried them through everything they have experienced so far. Medication may change hunger.It may change body weight. The portions of the food are decreasing. It may be changind their blood sugar regulation and other aspects of metabolic health. But it does not suddenly make the rest of the person irrelevant.

And I don’t want health care or wellness culture to make that mistake.

Shepherding Your Health During GLP-1 Weight Loss

I ended Part 1 talking about Romans 12:1 because that Scripture continues to shape the way I understand my body and the bodies I am entrusted to support. It began my revelation over nine years ago from today and it continues to create a conviction to:

Present your body.
Not conquer it.
We honor it no punish it.
There is no need to shrink to become acceptable.
We are commanded to present it. Care for it. Pay attention to it.

And I think that remains true when medication becomes part of someone’s story. Receiving medical treatment does not make someone less faithful. Losing weight does not make someone more faithful. Choosing not to pursue weight loss does not determine someone’s worth either. For me, sheperding or taking care of your only body asks a different question.

How am I caring for the body I have while it carries me through this season of my life?

The answer may be medication as part of the care. It could be strength training is part of that care. Maybe you’re not eating enough to care for or shepherd it. Sometimes rest is part of that care. Asking for help is part of that care. Its also not weakness it is wisdom and if you think I may be the person to help you, please schedule a comeback consult. I’d love to see if we are a good fit to work together. The goal isn’t to worship the body. It is to remember Who made it.

And perhaps that is why I keep resisting a conversation about GLP-1s that ends with pounds lost. There is a whole person standing on that scale. I don’t want us to lose sight of her.

GLP Strength Training: What I’m Watching Beyond the Scale

When I support a client using a GLP-1, these are some of the questions I continue to hold:

Because the question still isn’t only:

How much weight did you lose?

I want to know:

What are we helping you keep?

If you missed the beginning of this conversation, read Part 1: GLP-1 Weight Loss: Are We Still Talking About Health?, where I unpack what GLP-1 medications do, what the clinical trials actually show, the difference between weight loss and body composition, and why I believe health has to remain bigger than the number on the scale.

About the Author

De Bolton, B.S., NASM-CPT, CES, WLS, FNS, PN2-MHC

De Bolton is a holistic health practitioner, NASM Certified Personal Trainer, Corrective Exercise Specialist, Weight Loss Specialist, Fitness Nutrition Specialist, and Precision Nutrition Level 2 Master Health Coach. She holds a Bachelor of Science in Fitness and Exercise Science and works at the intersection of movement, nutrition, behavior change, and whole-person health.

References

Alissou, M., Demangeat, T., Folope, V., Van Elslande, H., Lelandais, H., Blanchemaison, J., Cailleaux, P.-E., Guney, S., Aupetit, A., Aubourg, A., Rapp, C., Petit, A., Godin, M., Vignal, L., Grigioni, S., Déchelotte, P., Colange, G., Coëffier, M., & Achamrah, N. (2026). Impact of semaglutide on fat mass, lean mass and muscle function in patients with obesity: The SEMALEAN study. Diabetes, Obesity and Metabolism, 28(1), 112–121. https://doi.org/10.1111/dom.70141

Look, M., Dunn, J. P., Kushner, R. F., Cao, D., Harris, C., Hunter Gibble, T., Stefanski, A., & Griffin, R. (2025). Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight. Diabetes, Obesity and Metabolism, 27(5), 2720–2729. https://doi.org/10.1111/dom.16275

Lopez, P., Taaffe, D. R., Galvão, D. A., Newton, R. U., Nonemacher, E. R., Wendt, V. M., Bassanesi, R. N., Turella, D. J. P., & Rech, A. (2022). Resistance training effectiveness on body composition and body weight outcomes in individuals with overweight and obesity across the lifespan: A systematic review and meta-analysis. Obesity Reviews, 23(5), e13428. https://doi.org/10.1111/obr.13428

Mechanick, J. I., Butsch, W. S., Christensen, S. M., Hamdy, O., Li, Z., Prado, C. M., & Heymsfield, S. B. (2025). Strategies for minimizing muscle loss during use of incretin-mimetic drugs for treatment of obesity. Obesity Reviews, 26(1), e13841. https://doi.org/10.1111/obr.13841

Mozaffarian, D., Agarwal, M., Aggarwal, M., Alexander, L., Apovian, C. M., Bindlish, S., Bonnet, J., Butsch, W. S., Christensen, S., Gianos, E., Gulati, M., Gupta, A., Horn, D., Kane, R. M., Saluja, J., Sannidhi, D., Stanford, F. C., & Callahan, E. A. (2025). Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society. The American Journal of Clinical Nutrition, 122(1), 344–367. https://doi.org/10.1016/j.ajcnut.2025.04.023

Sievenpiper, J. L., Ard, J., Blüher, M., Chen, W., Dixon, J. B., Fitch, A., Gigliotti, L., Khunti, K., Lecube, A., Lean, M. E. J., Mittendorfer, B., Pfeiffer, A. F. H., Ryan, D. H., Vilsbøll, T., & Van Gaal, L. F. (2026). Nutritional and lifestyle supportive care recommendations for management of obesity with GLP-1–based therapies: An expert consensus statement using a modified Delphi approach. Obesity Pillars, 17, 100228. https://doi.org/10.1016/j.obpill.2025.100228