You Are on Ozempic, Wegovy or Mounjaro. Strength Training Is Not Optional.

Around eleven percent of American adults are now taking a GLP-1 medication. In the UK that number is growing fast, driven by NHS prescribing for obesity and the parallel private market for Wegovy and Mounjaro. The results are real. People are losing significant amounts of weight.

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But the conversation around what that weight is made of has become louder, more urgent, and in places more confused. "Ozempic butt." "Ozempic face." The terms describe a visible change in body composition that some GLP-1 users experience as they lose weight. The muscle looks softer. The face looks older. The body looks like it has lost more than fat.

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There is something to this concern and something that has been overclaimed about it. Two things are true at once: some of what is being described is a misunderstanding of how major weight loss always changes the body, and some of it is a real and preventable problem. The solution to the preventable part is specific. It requires two things done consistently. Most GLP-1 patients are not doing either.

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First, What Is Actually Happening

When you lose a significant amount of weight, some of that loss comes from lean mass. This is true for everyone and every method. Bariatric surgery, caloric restriction, GLP-1 medications. The body cannot selectively remove only fat tissue from its total mass.

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Lean mass is not the same as muscle. It includes:

• Skeletal muscle: the tissue most people are thinking of when they hear "muscle loss"
• Connective tissue: tendons, ligaments, fascia
• Organ volume: organs reduce in mass as overall bodyweight drops
• Bone density: can decline with rapid weight loss
• Intracellular water: water bound to lean tissue that leaves when tissue is lost

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Some reduction in lean mass during major weight loss is expected, documented, and not unique to GLP-1 drugs. The figure that circulates most often is that 25 to 40 percent of weight lost on a GLP-1 may come from lean tissue. Obesity specialists who have spoken publicly about this have been careful to add the nuance: most of that lean mass is not skeletal muscle. Losing some lean mass is not the same as losing muscle at the rate the term "Ozempic butt" implies.

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The real risk is more specific than the headline suggests, and it sits in the interaction between appetite suppression and two habits most GLP-1 patients do not have.

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The Two Things That Determine the Outcome

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1. Protein intake

GLP-1 drugs suppress appetite significantly. For most users, this is the mechanism driving the weight loss. But appetite suppression does not discriminate between macronutrients. It reduces the desire to eat protein alongside everything else. Many GLP-1 users, without deliberate attention to their intake, are eating far below the threshold required to support muscle protein synthesis.

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The target: 1.6 to 2 grams of protein per kilogram of bodyweight per day. For someone weighing 80 kilograms, that is between 128 and 160 grams of protein daily. On a day where appetite is suppressed and total caloric intake might be 1400 to 1600 calories, hitting 160 grams requires deliberate effort. It does not happen by accident.

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What this looks like in practice: protein comes first in every meal. Not as an afterthought. A GLP-1 user eating smaller portions across the day needs to ensure those smaller portions are protein-dense. Chicken, eggs, Greek yogurt, cottage cheese, white fish. Dense sources that do not dilute limited appetite with low-value calories.

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2. Resistance training

This is the part that tends to be underweighted in the clinical conversation about GLP-1 medications, and it is the part that matters most.

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When you are in a caloric deficit, the body has no particular reason to maintain lean tissue that is not being regularly used under load. The deficit creates conditions where losing muscle is energetically efficient. Resistance training disrupts that logic. It provides a mechanical signal to muscle fibres that says: this tissue is load-bearing and should be preserved.

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Studies on caloric restriction consistently show that individuals who combine resistance training with a deficit preserve significantly more lean mass than those who use diet alone or diet combined with cardio. Not marginally more. Significantly more. Cardio does not provide the same signal. Running in a deficit tells your body very little about whether to hold onto your legs.

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Minimum effective dose: twice a week, hitting the major patterns. A squat, a hinge, a press, a pull. That is the session. That is enough to move the outcome.

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What the Difference Looks Like

This is not a minor distinction. The gap between doing these two things and not doing them is the gap between two meaningfully different outcomes.

A good outcome on a GLP-1 looks like this: primarily fat lost, muscle preserved, metabolic rate maintained, strength and physical function intact at the new weight, and a body that is far easier to maintain long term.

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A poor outcome looks like this: fat and muscle lost together, a slower resting metabolic rate, reduced physical capacity, and a body that is lighter but not meaningfully healthier. Weight regain becomes more likely, not less, because the metabolic baseline has dropped alongside the lean tissue.

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The medication creates the conditions for weight loss. Protein and resistance training determine what the weight is made of.

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Obesity specialists who have spoken about this explicitly have said that resistance training is not optional extra credit for GLP-1 patients. It is the difference between a good outcome and a poor one. Come and talk to us at Priority 6 before you decide that the lifting can wait until the weight is gone. It cannot.

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Book a free No Sweat Intro at priority6.co.uk to talk through what that looks like for you specifically. Click here

Priority 6 | Abingdon's longest-standing independent gym | Crossfit, Weight Loss, Fat Loss, Strength, Performance, Longevity www.priority6.co.uk | @priority6 | ollie@priority6.co.uk

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About the Author

Ollie Campbell is a British strength and conditioning coach, specialist fat loss coach, author of Build The Chain, nutrition coach, and founder of Priority 6 in Abingdon, Oxfordshire.

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