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Research: Exercise - The antidote to GLP-1 decline
Les Mills and UK Active have partnered to publish the first industry report on GLP-1 drugs and muscle mass, as Kath Hudson reports
The impact of weight loss drugs on skeletal muscle mass and the importance of exercise and strength training has been revealed in a new report from Les Mills and UK Active.
GLP-1 medications and muscle mass preservation: Implications and recommendations for the health and fitness sector is one of the first reviews of global academic evidence exploring how weight loss medications work, the side effects and how to avoid the loss of lean body mass through exercise and strength training.
Decreases in lean muscle mass over a 68-78 week period were the equivalent of a decade or more or human ageing
Led by Gillian Hatfield, associate professor at the University of the Fraser Valley, Canada, the review shows that loss of lean body mass is often an unintended consequence of taking weight loss medications. High caloric deficits lead to the body breaking down skeletal muscle tissue for energy and can have a significant impact on long-term health.
One paper reviewed in the study (Incretin-Based Weight Loss Pharmacotherapy: Can Resistance Exercise Optimize Changes in Body Composition?) found that over a 68-78 week period, GLP-1 use led to a decrease of between 6.0 and 6.9 kg of lean muscle mass, or the equivalent of "a decade or more or human ageing," with this accelerated ageing likely to be a critical issue for consumers.
The review shows that loss of muscle mass is particularly concerning for older adults due to the increasing risk of frailty and falls, which costs the NHS in the UK £2.3 billion every year.
Exercise and weight management
Combining exercise – particularly strength training – with a healthy diet can help mitigate muscle loss. This also has the added benefit of maintaining the amount of weight loss and minimising the overall muscle and bone loss found when taking the medications.
Exercising while using weight loss medications also helps to maintain weight loss after medication is discontinued by embedding better lifestyle habits.
Guidelines from the UK’s Chief Medical Officer recommend taking part in two-to-three strength training sessions a week and 150 minutes (two and a half hours) of moderate to vigorous physical activity a week, while guidance from the UK’s National Institute for Health and Care Excellence goes even further and suggests that those who are prescribed medicines for weight management should receive wraparound care focusing on diet, nutrition and increasing physical activity – including strength training – rather than using them as standalone treatments.
Uptake of the medication has surged, with the UK weight loss market experiencing average monthly growth of 24.6 per cent between October 2024 and March 2025. However, government efforts have focused on rollout rather than essential lifestyle changes.
The report authors are calling for the UK government to urgently convene the nutrition sector and the health and fitness sector on the required wraparound support offered to GLP-1 patients, with commitment and investment from the pharmaceutical sector.
Fitness professionals are given a number of practical recommendations to support consumers taking the drugs, including working proactively with the nutrition and obesity sector, upskilling the workforce and keeping abreast of up-to-date evidence.
Regular strength training is vital to our healthat all stages of life, but the research suggests this is especially true for people taking weight loss medications
Call for governments to act
Dr Matthew Wade, interim director of research at UK Active, says: “The rapid rollout of GLP-1s has shown dramatic results for patients, but in order to avoid weakening the body, there are simple and effective strength exercises that are essential for sustainable results.
“The health and fitness sector can support people taking weight loss medications, but we want to see the government go further by working with the fitness, nutrition and pharmaceutical industries to deliver the critical wraparound support patients need.”
Bryce Hastings, head of research at Les Mills, says: “Regular strength training is vital to our health at all stages of life, but the research suggests this is especially true for people taking weight loss medications.
"In addition to strength training two to three times a week, it's recommended that people taking weight loss medications accumulate 150 minutes (two and a half hours) of moderate to vigorous physical activity per week. Studies have shown this helps continue fat mass loss in the weight maintenance phase of treatment and lessen weight regain after treatment has stopped.
“More research is needed to deeper understand the relationship between weight loss medications and strength training, but the evidence and recommendations in our report are the start of the journey and offer practical next steps to better support the growing number of people taking weight loss medication,” said Hastings.
Accelerating ageing
Liz Terry, editor of HCM, said: “The finding that using GLP-1s can accelerate human ageing by ten years in 18 months will be a wake-up call for consumers and will motivate many to seek out exercise as a solution.
"This report gives the industry a vital update on the science behind the impact GLP-1s have on health, as well as highlighting the opportunities for the sector.
“We now have the opportunity to represent with one voice, adding our input to a debate that has – so far – been dominated by big pharma.
“We urge operators to reflect on the recommendations of this report and to partner with health professionals, the pharmaceutical industry and governments to make a real difference.
“We'd also like to see pharmaceutical companies seeking out partnerships in the health and fitness industry for the delivery of these vital interventions through collaboration, for the sake of consumers and their own reputations,” said Terry.
WHO guidelines
The World Health Organization has released its first guidelines on the use of GLP-1s More: www.hcmmag.com/WHOGLP-1
WHO confirmed its position that medication alone will not solve the problem and that a supportive approach is needed, including counselling on behavioural and lifestyle changes –including regular exercise – and societal change.
WHO also endorsed GLP-1s for longer-term use – a change from the original advice that the drugs should only be used for three to six months. More: www.HCMmag.com/WHOGLP-1
University of Oxford study
Research from the University of Oxford has found that people using weight loss drugs return to their original weight less than a year after stopping the injections. More: www.hcmmag.com/OxfordGLP-1
Key recommendations:
1. Governments should urgently convene discussions with the nutrition and dietetics sector and the health and fitness sector on the required wrap-around support for GLP-1 patients, with committed support and investment from the pharmaceutical sector.
2. The health and fitness sector should review its health offering, as well as working proactively with the nutrition and obesity sector to forge partnerships to support people taking weight loss medication.
3. There's a need to increase knowledge and understanding of weight loss medication across the health and fitness sector and its workforce, through the delivery of specific training.
4. The sector must influence consumer perceptions and continue to communicate up-to-date evidence of weight loss medication mechanisms, effectiveness, side effects and how exercise can support individuals taking weight loss medication.
This should include understanding the impact of side-effects and low energy levels associated with caloric deficits and the impact this may have on the volume and progression of exercise.
5. The sector needs to continue the encouragement of regular physical activity (150 minutes of moderate to vigorous activity per week) with a specific focus on resistance training two to three times a week.
6. There is a need to increase the healthcare sector’s knowledge and understanding of how the health and fitness sector can support individuals taking weight loss medication through regular physical activity that's undertaken to current guidelines.
7. Further research should be conducted on the role of exercise and in particular resistance training on the short- and long-term effectiveness of weight loss medication use. This should include evidence to support the specific protocols of resistance training.
