Exercise Regimens to Optimize GLP-1 Therapy
What type of exercise should I be doing while on GLP-1 Therapy?
One of the most frequent questions I get from patients starting GLP-1 Therapy with Tirzepatide (Mounjaro/Zepbound) or Semaglutide (Ozempic/Wegovy) is, “What type of exercise should I be doing while on GLP-1 medication?”
First, lets understand the main types of exercise. Exercise can get broken down into Aerobic exercise, Anaerobic (Strength and Resistance) excercise, Flexibility exercise, and balance exercise.
What is Aerobic Exercise?
Aerobic exercises include things like walking, jogging, hiking, swimming, cycling and typically involve exercises that use oxygen to increase your heart rate and breathing. Aerobic exercise is beneficial in improving your cardiovascular fitness, lowering your blood pressure, and boosts your energy levels. These types of exercises are very effective for burning calories and are associated with more weight loss then anaerobic exercise. Aerobic exercises use oxygen to produce energy and are typically lower in intensity and longer in duration than anaerobic exercise.
What is Anaerobic Exercise?
Anaerobic exercises include things like weightlifting, sprinting, jumping, HIIT training, and plyometrics and use energy stored in muscles as opposed to oxygen. Benefits of anaerobic exercise include increasing muscle mass, helping the body use insulin more efficiently (something GLP-1’s like Semaglutide and Tirzepatide also assist with), decreases the risk of osteoporosis, prevents cardiac aging, lowers cardiovascular risk, and may help to increase your metabolism and resting metabolic rate.
What Exercise is Best for Weight Loss and Weight Maintenence?
While exercise is important for weight loss and even more important for weight maintenence, the effects of exercise alone on weight loss are neglible compared to diet. The most important component of weight loss is running a caloric deficit over a perior of time. An average caloric deificit of 500 – 750 calories per day is recommended for most successful diets. A healthy weight loss goal that I aim for in my patients is a consistent weight loss of 1.5 – 2 lb per week.
GLP-1 medications like Tirzepatide and Semaglutide are very effective at suppressing your appetite, limiting portion sizes, and allowing you to consistently run a caloric deficit. This is what makes them such great weight loss medications! This consistent caloric deficit combined with other ways they optimize your metabolism allows your body to burn through existing fat reserves as a source of energy and thus lose weight.
What exercise does Dr. Quiros recommend for his patients on GLP-1 Therapy?
I recommend a training regimen focusing primarily on Strength and Resistance training while taking GLP-1 medications. I recommend 30-45 minutes per day, 3-4 days per week as a starting point. If you enjoy aerobic exercise you can continue to do it as part of your wellness routine, but it should be secondary to strength and resistance training for patients taking Semaglutide or Tirzepatide for weight loss. I recommend this for the following reasons:
1. Optimize Body Composition:
The caloric deficit produced by taking semaglutide or tirzepatide is more than enough to achieve significant weight gain. The concern is not if you will lose weight but rather how you lose the weight. By focusing on strength and resistance training you will be signaling to your body to hold on to your existing muscle mass and ideally build additional muscle. This will mitigate the loss of muscle mass that can occur when you are running a caloric deficit and amplify the rate that you burn through fat a source of energy in a caloric restricted state.
2. Increase you metabolism:
If you run a caloric deficit over a prolonged period of time your metabolism may slow down. This is a result of your body becoming more efficient as a response to running a prolonged caloric deficit. This is also one of the reasons patients can see their weight loss plateau. By performing anaerobic strength and resistance exercises regularly and building muscle mass you will increase your metabolism and ensure that your resting metabolic rate does not decrease as you continue to lose weight.
3. Mitigate Osteoporosis:
One of the side effects described in the clinical trials for Semaglutide and Tirzepatide was osteoporosis. This is particularly concerning in women over 65 and post-menopausal patients. Some loss of bone density is natural with weight loss as your bones are not subject to the same weight loading and stress forces, but too much can be pathological. Anaerobic exercise, particularly resistance training, can be highly effective in decreasing the risk of osteoporosis by increasing bone density and strength due to the mechanical stress it places on bones, which stimulates bone formation and helps prevent bone loss. Essentially, when you engage in resistance training, your body responds by building stronger bones to handle the added stress.
This post was prepared by:
Dr. Mario I. Quiros
Good Hearts Health Owner and Founder
Dipolomate of the American Board of Obesity Medicine
More useful Info on benefits of Aerobic vs. Anaerobic Exercise:
https://www.shape.com/fitness/tips/aerobic-vs-anaerobic-exercise