More and more of my clients over 40 are asking me the same question: “I’ve started Ozempic. Do I still need to exercise?” The short answer is yes. In fact, if you are taking Ozempic or a similar medication, exercise, and especially strength training, may be more important than ever. Here’s why, and what to do about it.
Please note: this article is general fitness information, not medical advice. Ozempic is a prescription medication. Always follow your doctor’s guidance, and talk to your doctor or pharmacist before starting a new exercise program or changing your diet while on any medication.
What Is Ozempic?
Ozempic is the brand name for semaglutide, a GLP-1 medication. In Canada it is approved to help manage type 2 diabetes. The same drug, at a higher dose, is sold as Wegovy for weight management. These medications mimic a natural hormone that helps control blood sugar, slows how quickly your stomach empties and reduces appetite, so many people eat less and lose weight.
For many people, that is life-changing. But there is a catch that doesn’t get talked about enough.
The Hidden Problem: Losing Muscle, Not Just Fat
When you lose weight quickly, you don’t only lose fat. You can also lose lean mass, which includes muscle. In the large STEP 1 clinical trial of semaglutide, a body-scan sub-study found that roughly 40% of the weight participants lost was lean mass. Lean mass also includes water and other tissue, so not all of that was muscle, but the message is clear: without the right habits, a meaningful part of the weight you lose can be the muscle you want to keep.
After 40, that matters a lot. We already lose muscle naturally as we age (this is called sarcopenia). Muscle is what keeps you strong on the stairs, steady on your feet, able to carry groceries and play with grandchildren. It also supports your metabolism and helps protect your bones and joints. And once muscle is lost, it is much harder to rebuild than to keep.
The goal, then, is not just to lose weight. It is to lose fat while keeping your muscle. That is exactly where exercise comes in.
5 Ways Exercise Helps While You’re on Ozempic
- Protects your muscle. Strength training tells your body that your muscles are still needed, so it holds on to them while you lose fat.
- Keeps your metabolism working. More muscle means your body burns more energy, even at rest.
- Supports your bones and balance. Strength and balance work lowers the risk of falls and fractures, which is especially important for women after menopause.
- Improves blood sugar control. Active muscles use glucose, which works alongside the medication.
- Helps you keep the weight off. Regular exercise is one of the strongest habits for maintaining weight loss over the long term, including if you ever stop the medication.
What Kind of Exercise Is Best?
1. Strength training: your number one priority
Aim for at least 2 to 3 strength sessions a week on non-consecutive days, working all the major muscle groups: legs, hips, back, chest, shoulders, arms and core. You don’t need a gym. Chair squats, wall push-ups, glute bridges, resistance band rows and carrying household weights all count. Start light, focus on good form, and add reps or a little weight gradually.
2. Regular cardio
Work up to about 150 minutes a week of moderate activity, such as brisk walking, cycling or swimming. That could be 30 minutes, 5 days a week, or shorter 10-minute walks after meals, which can also help with blood sugar.
3. Balance and flexibility
Add a few minutes of balance work (standing on one leg near a counter, heel-to-toe walking) and gentle stretching a few times a week. It keeps you moving well and helps prevent injuries.
A Sample Beginner Week
| Day | Activity |
|---|---|
| Monday | Strength training (full body, 25 to 30 minutes) |
| Tuesday | Brisk walk, 30 minutes |
| Wednesday | Strength training |
| Thursday | Walk or easy bike ride, 30 minutes, plus stretching |
| Friday | Strength training |
| Saturday | Longer walk or an active hobby |
| Sunday | Rest and gentle stretching |
Not sure where to start? Our 10 free beginner workout plans you can do at home include 5 muscle-toning workouts that are perfect for this.
Tips for Exercising Comfortably on Ozempic
- Eat protein first. Because these medications reduce your appetite, it’s easy to under-eat protein, which your muscles need. Start each meal with a protein food such as eggs, Greek yogurt, fish, chicken, tofu, beans or cottage cheese. Ask your doctor or a dietitian how much protein is right for you.
- Drink enough water. GLP-1 medications can reduce thirst, and side effects like nausea can make dehydration more likely. Sip water before, during and after exercise.
- Work around side effects. Nausea and tiredness are common, especially after starting or increasing a dose. On those days, choose a gentle walk or light stretching instead of skipping movement altogether, and avoid exercising right after a large meal.
- Know the signs of low blood sugar. If you also take insulin or certain other diabetes medications, exercise can lower your blood sugar further. Stop and seek advice if you feel shaky, dizzy, sweaty, confused or unusually weak, and ask your doctor whether you should check your blood sugar around workouts.
- Start low and go slow. If you are new to exercise, 10 to 15 minutes a day is a great start. Consistency matters far more than intensity.
The Bottom Line
Ozempic can be a powerful tool, but it works best as part of a plan, not instead of one. Pair it with regular strength training, daily movement, enough protein and plenty of water, and you give yourself the best chance of losing fat, keeping your muscle and feeling strong for years to come.
If you would like help building a safe, effective program around your medication, health history and goals, I work one-on-one with adults over 40, online or in your home. Book a $40 trial session and let’s get you started.
Irina Marchenkova, ISSA Master Trainer, Fit at Forty PLUS Club
Sources
- Wilding JPH, et al. “Once-Weekly Semaglutide in Adults with Overweight or Obesity” (STEP 1). New England Journal of Medicine, 2021.
- Cleveland Clinic: How to Exercise While Taking GLP-1 Medications
- ukactive: GLP-1 Medications and Muscle Mass Preservation